Oral manifestations in women using hormonal contraceptive methods: a systematic review.

OBJECTIVES: To investigate the oral manifestations in women of reproductive age using hormonal contraceptive methods. MATERIALS AND METHODS: This review is based on the PRISMA statement. A literature search incorporated observational studies from the last 21 years. An investigative question was formulated using the PICO model, studies were selected, and a quality analysis was performed using the modified STROBE guidelines. A bibliometric analysis was performed, and the data were examined. RESULTS: Thirteen articles were included, with the majority evaluating periodontal status. Others analyzed factors such as the presence of alveolar osteitis, oral candidiasis, and salivary microbiome dysbiosis. Ten articles were deemed to have a low risk of bias. CONCLUSIONS: Hormonal contraceptives may increase the risk of alveolar osteitis following tooth extraction and increase the presence of the Candida species in the oral cavity. They also affect the periodontium, such as the frequent development of gingivitis, but do not lead to changes in the salivary microbiome. CLINICAL RELEVANCE: The increasing number of women using hormonal contraceptives and the knowledge that these contraceptives can produce oral cavity alterations underscore the need to evaluate the oral manifestations found in these women.

Game-changing perspectives: A dataset on student perceptions of sustainable mobility pre- and post escape room intervention.

The dataset aims to examine the prior and acquired knowledge in an Escape Room (ER) experience on sustainable mobility. In addition, the data could also be used to identify possible correspondences between some mobility behaviors and the predisposition to learn sustainable mobility concepts to foster attitude change. To meet these objectives, an ER on sustainable mobility was conducted and a questionnaire was given before and after the activity to 173 students from various schools between 5th grade of primary school and 1st year of compulsory secondary school (10-13 years old). The questionnaire was divided into two parts. The first part included social demographics questions (gender, family members, place of residence) and mobility habits (number of cars in the family, bus use, cycling). The second part included questions related to sustainable mobility topics with 14 items. Data was collected between December 2022 and February 2023.

Spanish validation of two social media appearance-related constructs associated with disordered eating in adolescents: The Appearance-related Social Media Consciousness scale (ASMC) and the Critical Thinking about Media Messages scale (CTMM).

Appearance-related constructs underlying social media are negatively associated with mental health. However, their impact on the Spanish population is still unexplored. The present study aimed to validate the Spanish versions of two appearance-related scales: (1) the appearance-related social media consciousness (ASMC) scale; and (2) the critical thinking about media messages (CTMM) scale. Translation and cultural adaptation of the scales were carried out. The scales' psychometric properties were assessed using exploratory and confirmatory factor analyses, measurement invariance across gender (boys vs. girls) and age groups (early adolescents vs. middle adolescents), internal consistency, and convergent validity. The sample included 803 Spanish secondary school adolescents aged between 12 and 18 (Mage = 15.1, 47.9% girls, 47.2% boys, 4.9% non-binary gender/others). The exploratory factor analyses replicated original one-factor structures of both scales, which was verified using confirmatory factor analysis. Regarding the ASMC Scale, a re-specified model (allowing for error correlations between Items 1-2) presented an adequate fit. Both models were invariant across gender and age groups. Excellent internal consistency was found. Bivariate correlations between the ASMC and eating disorders related variables (body esteem, disordered eating, self-esteem, sociocultural attitudes towards appearance, and general mental health) supported its convergent validity and proved ASMC to be a potential target for future preventive eating disorder interventions. However, the CTMM scale correlated only with sociocultural pressures, thus, further research is needed to assess the validity of the CTMM in Spanish samples.

Weight bias internalization among adolescents in Spain: psychological correlates across gender diversity and weight status / La internalización de los prejuicios de peso entre los y las adolescentes en España: correlatos psicológicos en función del género y el estatus de peso

Weight bias internalization refers to the negative weight-related attributions applied to oneself, but it does not just occur in the highest weight statuses, but rather exists across the entire weight spectrum. There is a negative impact associated to increase psychological problems in adults, however, it has been less studied among the adolescent Spanish population. In this study, we assess the relationship between the internalization of weight bias, social attitudes towards appearance, body appreciation and self-esteem, and potential differences regarding gender and weight status. A community sample of 1258 Spanish adolescents between 12 and 18 years old (46.3% male gender; Mage = 15.58; SD = 1.59; 49.5% female gender; Mage = 15.59; SD = 1.67; and 4.1% non-binary gender; Mage = 14.86; SD = 2.86) participated in the study. The Modified Weight Bias Internalization Scale (WBIS-M), the Rosenberg Self-Esteem Scale (RSES), and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) were used. ANOVA’s test and bivariate correlations were performed. The results suggest that females (t = -.55; p ≤ .001) and non-binary adolescents (t = .64; p ≤ .01) have higher levels of WBI-M compared to males. Regarding weight status, the group with obesity (t = 1.39; p ≤ .001) and the group with overweight (t = -.81; p ≤ .001) have higher levels of WBI-M compared to the normal weight group. Significant correlations between WBI-M and the assessed psychological variables were found in the total sample, and across all-gender and weight categories, except for the underweight group. These results are a first approximation to the internalization of weight bias in a Spanish adolescent sample and highlight the need to introduce this concept in prevention and psychological interventions in school context. (AU)

La internalización de los prejuicios de peso hace referencia a las atribuciones negativas relacionadas con el peso aplicadas a uno mismo/a, lo cual no ocurre únicamente en las personas con un estatus de peso elevado, sino en todo el rango de pesos. En adultos, existe evidencia de su impacto negativoasociados a incrementar problemas psicológicos; aunque se ha estudiado en menor medida en la población adolescente. El objetivo de este estudio fue examinar la relación entre la internalización de prejuicios de peso, las actitudes socioculturales hacia la apariencia, la apreciación corporal y el nivel de autoestima, y analizar las posibles diferencias en función del género y del estatus de peso. Participaron 1.258 adolescentes españoles de una muestra comunitaria entre 12 y 18 años (46.3% género masculino; Medad = 15.58; DT = 1.59; 49,5% género femenino; Medad = 15.59; DT = 1.67; y 4.1% género no binario; Medad = 14.86; DT = 2.86). Se utilizaron la escala de internalización de prejuicios de peso modificado (WBIS-M), la escala de autoestima de Rosenberg (RSES) y el cuestionario de actitudes socioculturales hacia la apariencia (SATAQ-4). Se realizó la prueba ANOVA y correlaciones bivariadas. Los resultados sugieren que el grupo identificado con el género femenino (t = -.55; p ≤ .001) y con el no binario (t = .64; p ≤ .01) muestran niveles más altos de internalización del sesgo de peso en comparación con el género masculino. En cuanto al estado ponderal, el grupo con obesidad (t = 1.39; p ≤ .001) y el grupo con sobrepeso (t = -.81; p ≤ .001) presentan niveles más altos de internalización de prejuicios de peso en comparación con el grupo con normopeso. Se encontraron correlaciones significativas entre las puntuaciones del WBIS-M y las variables psicológicas evaluadas en la muestra total yen todas las categorías de género y peso, con la excepción del grupo de bajo peso. (AU)

Desarrollo y validación española de la escala de sucesos vitales estresantes (SVE-I) en escolares (8-12 años) / Development and validation of the stressful life events questionnaire (SVE-I) for Spanish children (8-12 years old)

La acumulación de Sucesos Vitales Estresantes (SVE) supone un factor de riesgo para la salud mental en la infancia, sin embargo, no contamos con un cuestionario en español validado en la segunda infancia. Este estudio presenta el desarrollo y la validación de una nueva escala (SVE-I) de autoinforme para evaluar la acumulación de SVE en menores de 8 a 12 años españoles. Un panel de expertas participó en la evaluación de la adecuación de la escala. Se realizaron comprobaciones en un grupo focal para asegurar la aceptabilidad y comprensión de los ítems. 504 menores de cuatro centros escolares de Madrid (Medad = 10.1; DTedad = 1.28; 56.5 % chicos) participaron en el estudio, completando la batería de cuestionarios. El análisis factorial confirmatorio mostró una estructura de tres factores (estrés familiar, estrés socio-escolar y salud), con una consistencia interna de la escala global adecuada (αordinal = .83). Para la evidencia de validez concurrente, se encontró una asociación positiva entre la acumulación de SVE y la sintomatología ansiosa de los menores. Los resultados indican que la SVE-I es un instrumento válido y fiable. Esta escala pretende ser una herramienta sencilla y útil para el cribado de casos en riesgo desde la escuela y Atención Primaria. (AU)

The accumulation of Stressful Life Events (SVE) is a risk factor for mental health in childhood, however, there is no adequate questionnaire validated in Spanish for its use during childhood. This study presents the development and validation of a new scale (SVE-I), a self-report questionnaire for assessing the accumulation of SVE in Spanish children aged 8 to 12 years. A panel of experts evaluated the adequacy of the scale. The acceptability and understanding of the items were ensured by a small focus group. 504 children from four schools in Madrid (Mage = 10.1; SDage = 1.28; 56.5 % boys) participated in the study, completing a battery of questionnaires. Confirmatory factor analysis showed a structure of three factors: (family stress, socio-school stress, and health), with an adequate internal consistency of the global scale (α = .83). For concurrent validity, a positive association was found between the accumulation of EVS and the anxious symptomatology of the children. The results indicate that the SVE-I is a valid and reliable instrument. This scale aims to be a useful tool in the school context and clinical practice. (AU)

ENTREN-F family-system based intervention for managing childhood obesity: Study protocol for a randomized controlled trial at primary care.

BACKGROUND: Pediatric obesity is a primary public health concern, and designing effective programs for managing it is of the utmost importance. The objective of this study was to describe the protocol study of a three-arm, parallel, randomized controlled trial aimed at assessing the efficacy of a family-system-based intervention ("ENTREN-F" program) for managing childhood obesity, compared to the "ENTREN" program (no "F" - without specific family-system-based workshop) and a control group (behavioral monitoring). METHODS/DESIGN: The ENTREN-F program was a multicomponent family-system-based intervention carried out by a multidisciplinary team in the primary health care setting. The program targeted children between 8 and 12 years with overweight and obesity (P ≥ 85th). Parents were actively involved in the process. The contents were designed using the Cognitive Behavioral Therapy (CBT) principles. The program comprised individual behavioral monitoring, a healthy habits workshop for children and their parents, a CBT workshop for children, and a family-system-based workshop for parents, enhancing parental management skills plus family functioning. The trial's primary outcomes included changes in child body mass index (BMI) z-scores, child's psychological well-being, and family functioning over six months. Secondary outcomes included changes in eating behavior, physical activity, self-esteem, parental distress, parental feeding practices, and parental modeling. DISCUSSION: To our knowledge, this is one of the few randomized controlled trials to assess the efficacy of a multicomponent program that considers health from a comprehensive perspective, trying to improve children's psychological well-being and family functioning besides weight loss. This study, therefore, addresses a gap in the literature. If found to be efficacious, it suggests a new potential health service for translation into National Primary Health Care services in Spain, one of the ten countries with the highest prevalence of obesity in Europe.

Family-reported barriers and predictors of short-term attendance in a multidisciplinary intervention for managing childhood obesity: A psycho-family-system based randomised controlled trial (ENTREN-F).

OBJECTIVE: This study was aimed to examine patient enrolment in the pre-intervention stage, family-reported barriers, attendance rates and underlying predictors of short-term attendance in a family-system-based randomised controlled trial for managing childhood obesity in children aged 8-12-years-old (ENTREN-F). METHOD: Psychosocial and anthropometric measures were collected through primary health referral. The data were used for descriptive analyses of sample characteristics and linear regression analyses. RESULTS: Low enrolment rates and several family-reported barriers were observed in the pre-intervention stage. Logistical barriers were the most frequent family-reported reason for attrition in the different stages of the study. Having a first face-to-face orientation session with the families and the use of motivational interviewing helped to improve adherence in the initial phases of the study. After 6 months of intervention, family based treatments (FBTs) under consideration achieve greater adherence compared with the standard intervention. Moreover, family involvement was a predictor of success for better treatment adherence rates. By contrast, participants who attended a brief standard intervention, mothers with primary education, greater body mass index, higher levels of depressive symptomatology and more critical comments towards their children, children with higher weight status and lower levels of self-reported depressive symptoms at baseline attended interventions less frequently. CONCLUSIONS: In future programmes a comprehensive screening of modifiable factors related to family and their setting characteristics is paramount prior to intervention, identifying key barriers related to drop-out, especially in the case of less-advantaged families.

Using structural equation modeling to understand family and psychological factors of childhood obesity: from socioeconomic disadvantage to loss of control eating.

PURPOSE: Current study aimed to empirically test the Hemmingsson's theoretical model of childhood obesity which emphasizing the importance of family environment and the emotional distress of parents as influential variables in the emotional distress of the child and subsequent weight gain. This study also tested the hypothesis that the emotional distress of the child triggers a weight gain-inducing behavior (loss of control eating) to suppress negative emotions. METHODS: Families of 220 Spanish children participated in the study (28.2% normal, 35.1% overweight and 32.2% obesity), aged between 8 and 12. The evaluation included a clinical interview and a battery of questionnaires. RESULTS: Structural equation models were computed according to the steps proposed by theoretical model. Fit indices were acceptable suggesting that the data adequately fit the hypothesized model. Path coefficients in the final model were statistically significant showing a relationship between socioeconomic status, the emotional distress of parents, family environment, the emotional distress of children, loss of control eating and child's BMI Z-score. CONCLUSION: Considering this relation between emotional distress and child weight status, childhood obesity intervention programs may benefit from targeting family environment and the potential role that food is playing in the regulation of children's distress. LEVEL OF EVIDENCE: Level III: Cohort analytic study.

Development of a Method to Potentially Substitute Direct Evaluation of Mesopic Visual Acuity in Drivers.

(1) Background: In mesopic lighting conditions, or under adverse environmental circumstances, visual information is reduced, which increases the risk of traffic accidents. This effect could be reduced with a precise evaluation of the visual function under mesopic conditions, but it is difficult to replicate in clinics. This study aims to develop an easy-to-adopt method to evaluate mesopic visual acuity (VA) in drivers. (2) Methods: Prospective and observational study in drivers. logMAR mesopic VA was compared with photopic VA measured under different combinations of contrast charts and filters to find the combination that responds best to mesopic conditions. (3) Results: Fifty-six drivers were examined. The best correlation was found with an 80% density filter and a Weber contrast chart of 20%. The logMAR VA for this combination was 0.01 ± 0.11, which was close to the mesopic VA values (0.01 ± 0.12). The difference between both logMAR VA was 0.00 ± 0.06 (R = 0.86; p ≤ 0.001; ICC = 0.86). (4) Conclusions: The use of 20% contrast optotypes and the interposition of an 80% filter under photopic conditions provide VA values similar to those measured under mesopic lighting conditions, making this simple system a good predictor of mesopic VA values.

Linking Psychosocial Stress Events, Psychological Disorders and Childhood Obesity.

There is scientific evidence that supports a strong association between early exposure to stressful life events and the presence of health complications throughout adulthood and, to a lesser extent, in adolescence and childhood. The aim of this study was to examine the accumulation of Psychosocial Stress Events (PSE) and the prevalence of mental disorders in children from 8 to 12 years. The association between these factors and child weight measurements was analysed. A cross-sectional study was conducted among 200 children classified by weight status (obesity, overweight and normal-weight). The assessment was carried out in primary care centres and primary schools. An experienced team carried out a structured medical-psychosocial history and a semi-structured interview aimed at identifying an early diagnosis of psychological disorders. Children filled out a questionnaire to evaluate PSE. The obesity group presented the greatest accumulation of PSE and highest prevalence of psychiatric diagnosis, compared to overweight and normal-weight children. To exceed four or more stressful events was positively associated with psychological problems and child body mass index (BMI z-score). A predictive model confirmed the interaction between a larger number of PSE and the occurrence of a psychiatric diagnosis as variables that predispose children by 26.2 times more to increased weight status. In conclusion, the accumulation of PSE in the family, school and social environments of the children was related to greater psychological distress. If not managed, the likelihood of suffering from other health complications, such as excess weight, may increase. It is important to monitor these variables to ensure positive health outcomes while specifically addressing childhood obesity. This is especially relevant for children from a disadvantaged social background and disharmonious family environments.

Identifying Loss of Control Eating within Childhood Obesity: The Importance of Family Environment and Child Psychological Distress.

This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC eating based on a dysfunctional family environment. A cross-sectional study was conducted among 239 families. The assessment measured family expressed emotion, family adaptability and cohesion, child levels of depression and anxiety, body esteem, and disordered eating attitudes. The assessment was carried out in primary care centers and primary schools. Child body mass index (BMI) was associated with higher expressed emotion, psychological distress, and disordered eating symptomatology. Children with obesity and LOC presented higher BMI, poorer body esteem, and more disordered eating attitudes than children without LOC. Children with overweight/obesity, both with or without LOC, exhibited higher psychological distress and emotional overinvolvement than normal-weight children. A partial mediation of depression or anxiety and disordered eating attitudes between expressed emotion and LOC was found. Findings support that children with overweight/obesity show more family and psychological distress. Body esteem issues and disordered eating attitudes could alert the presence of LOC in children with obesity. The function of LOC might be to cope with psychological distress that may appear in a dysfunctional family environment.

Ambiente familiar, actividad física y sedentarismo en preadolescentes con obesidad infantil: estudio ANOBAS de casos-controles / Family environment, physical activity and sedentarism in preadolescents with childhood obesity: ANOBAS case-control study

OBJETIVO: Comparar los niveles de actividad física y sedentarismo en niños con obesidad y normopeso, y analizar el nivel de actividad física del cuidador principal junto con el ambiente familiar. DISEÑO: Estudio caso-control. Emplazamiento: Un centro de salud y colegios de la Comunidad de Madrid. PARTICIPANTES: Un total de 50 niños con obesidad entre 8 y 12 años (GO; P > 97) y sus madres, fueron emparejados por edad, sexo y estatus socioeconómico de sus padres (1:1) con 50 niños con normopeso (GN; P < 85). MEDICIONES PRINCIPALES: Los niveles de actividad física se midieron por acelerometría (ActiGraph GT3X), la actividad física del cuidador principal con el cuestionario de actividad física (IPAQ) y el ambiente con el cuestionario de ambiente familiar (HES-S). RESULTADOS: El grupo GO presentó menos actividad física de tipo vigoroso al compararse con el grupo GN. La actividad física vigorosa en el GO se asoció al modelado y las políticas parentales respecto a la actividad física. Un análisis de regresión múltiple muestra que el 21% de la varianza del estatus de peso de los niños se explicaba por la actividad física vigorosa y el índice de masa corporal materno. CONCLUSIONES: Los niveles de actividad física vigorosa y el ambiente familiar difieren entre los niños con obesidad y normopeso. Por lo tanto, es importante seguir trabajando la conciencia de enfermedad y la promoción de hábitos saludables desde Atención Primaria y el contexto escolar e institucional

OBJECTIVE: The aim of this study is to compare the levels of physical activity and sedentary behaviours in children with obesity and normal weight through accelerometer measures, and analyze the family environment related to physical activity. DESIGN: Case-control study. LOCATION: A health center and colleges of the Community of Madrid. PARTICIPANTS: A total of 50 obese children between 8 and 12 years of age (P > 97) and their mothers were matched by age, sex and socioeconomic status of their parents (1: 1) with 50 children with normopeso (GN; P < 85). MAIN MEASUREMENTS: Physical activity levels were measured by accelerometer (ActiGraph GT3X), levels of physical activity of the primary caregiver were measured through physical activity questionnaire (IPAQ) and the environment in relation to the physical activity was measured by the Home Environment Scale (HES-S). RESULTS: The group GO showed less vigorous physical activity than their peers in the GN group. Vigorous physical activity in the GO group was associated with modeling and parental policies regarding physical activity. A multiple regression analysis revealed that 21% of the variance of weight status of children was explained by sex, vigorous physical activity and maternal body mass index. CONCLUSIONS: The levels of vigorous physical activity and the family environment differ between children with obesity and normal weight. Therefore, it is important to continue working on the awareness of illness and the promotion of healthy habits from Primary Care and the school and institutional context

[Family environment, physical activity and sedentarism in preadolescents with childhood obesity: ANOBAS case-control study]. / Ambiente familiar, actividad física y sedentarismo en preadolescentes con obesidad infantil: estudio ANOBAS de casos-controles.

OBJECTIVE: The aim of this study is to compare the levels of physical activity and sedentary behaviours in children with obesity and normal weight through accelerometer measures, and analyze the family environment related to physical activity. DESIGN: Case-control study. LOCATION: A health center and colleges of the Community of Madrid. PARTICIPANTS: A total of 50 obese children between 8 and 12 years of age (P > 97) and their mothers were matched by age, sex and socioeconomic status of their parents (1: 1) with 50 children with normopeso (GN; P < 85). MAIN MEASUREMENTS: Physical activity levels were measured by accelerometer (ActiGraph GT3X), levels of physical activity of the primary caregiver were measured through physical activity questionnaire (IPAQ) and the environment in relation to the physical activity was measured by the Home Environment Scale (HES-S). RESULTS: The group GO showed less vigorous physical activity than their peers in the GN group. Vigorous physical activity in the GO group was associated with modeling and parental policies regarding physical activity. A multiple regression analysis revealed that 21% of the variance of weight status of children was explained by sex, vigorous physical activity and maternal body mass index. CONCLUSIONS: The levels of vigorous physical activity and the family environment differ between children with obesity and normal weight. Therefore, it is important to continue working on the awareness of illness and the promotion of healthy habits from Primary Care and the school and institutional context.

Flexural Strength Prediction Models for Soil⁻Cement from Unconfined Compressive Strength at Seven Days.

Soil⁻cement is an environmentally friendly road construction technique for base and subbase materials, which allows employing soils placed in the right-of-way of the road or in the surroundings, by improving its engineering properties. With this technique, it is possible to reduce the over-exploitation of quarries, the necessity of landfills and the pollutant gas emission due to the reduction of aggregate fabrication and transport. The manufacturing of soil⁻cement is generally controlled by means of the Uniaxial Compressive Strength (UCS) test at seven days, according to the regulations of each country. Nonetheless, one of the properties that best defines the performance of soil⁻cement is the Flexural Strength (FS) at long term, usually at 90 days. The aim of this paper is to develop new equations to correlate the UCS and the FS at long term and the UCS at seven days and at 90 days. Obtained results validate the proposed models and, hence, the flexural strength can be predicted from the Uniaxial Compressive Strength at seven days, allowing, if necessary, correcting measures (recalculation or rejection) in early stages of the curing time to be taken.

Silkworm Gut Fiber of Bombyx mori as an Implantable and Biocompatible Light-Diffusing Fiber.

This work describes a new approach to the delivery of light in deeper tissues, through a silk filament that is implantable, biocompatible, and biodegradable. In the present work, silkworm gut fibers (SGFs) of Bombyx mori L., are made by stretching the silk glands. Morphological, structural, and optical properties of the fibers have been characterized and the stimulatory effect of red laser light diffused from the fiber was assayed in fibroblast cultures. SGFs are formed by silk fibroin (SF) mainly in a ß-sheet conformation, a stable and non-soluble state in water or biological fluids. The fibers showed a high degree of transparency to visible and infrared radiation. Using a red laser (λ = 650 nm) as source, the light was efficiently diffused along the fiber wall, promoting a significant increment in the cell metabolism 5 h after the irradiation. SGFs have shown their excellent properties as light-diffusing optical fibers with a stimulatory effect on cells.

[Mixed design for the evaluation of the Mesoamerica Health 2015 initiative]. / Diseño mixto de evaluación de la iniciativa Salud Mesoamérica 2015.

Since the Salud Mesoamerica 2015 initiative (SM-2015) aim is to improve health and nutrition conditions of those most vulnerable in Mesoamerica, the goal of the evaluation is to generate evidence of the joint effectiveness of a package of interventions designed to improve the health conditions. We propose a mix design for the evaluation, which will allow to know the magnitude of changes attributable to the interventions, as well as the meanings of these changes for the target population, taking into account the specificities of each country. The main axis of this design is a locality panel where information about individuals, households, and health facilities (first and second level) will also be collected. The evaluation design described in this paper was developed between June and December, 2009, and it was integrated during workshops in Cuernavaca (Mexico), Managua (Nicaragua), and San Jose (Costa Rica). The proposed design will allow to generate evidence about the joint effectiveness of the package of interventions proposed for the SM-2015. The success of this design rests on the political commitment of countries and donors.

Diseño mixto de evaluación de la iniciativa Salud Mesoamérica 2015 / Mixed design for the evaluation of the Mesoamerica Health 2015 initiative

El propósito de la iniciativa Salud Mesoamérica 2015 (SM-2015) es mejorar el estado de salud y nutrición de la población con mayor grado de vulnerabilidad en Mesoamérica. El objetivo de la evaluación es generar evidencia sobre la efectividad conjunta de un paquete de intervenciones diseñadas para mejorar las condiciones de salud en la región. Se propone una evaluación de impacto con métodos mixtos, para conocer la magnitud de los cambios atribuibles a la SM-2015, e identificar los significados de estos cambios para la población objetivo, en el contexto de cada país. El eje conductor es un panel de localidades con el que se colectará información de individuos, hogares y unidades de salud de primero y segundo nivel de atención. El diseño que se describe en este documento fue desarrollado entre junio y diciembre de 2009, y su articulación se llevó a cabo en talleres realizados en Cuernavaca (México), Managua (Nicaragua), y San José (Costa Rica). El diseño propuesto permitirá generar evidencia sobre la efectividad conjunta del paquete de intervenciones propuesto en los planes maestros mesoamericanos. El éxito de este diseño radica en la voluntad y en el compromiso político de los países y los donantes.

Since the Salud Mesoamerica 2015 initiative (SM-2015) aim is to improve health and nutrition conditions of those most vulnerable in Mesoamerica, the goal of the evaluation is to generate evidence of the joint effectiveness of a package of interventions designed to improve the health conditions. We propose a mix design for the evaluation, which will allow to know the magnitude of changes attributable to the interventions, as well as the meanings of these changes for the target population, taking into account the specificities of each country. The main axis of this design is a locality panel where information about individuals, households, and health facilities (first and second level) will also be collected. The evaluation design described in this paper was developed between June and December, 2009, and it was integrated during workshops in Cuernavaca (Mexico), Managua (Nicaragua), and San Jose (Costa Rica). The proposed design will allow to generate evidence about the joint effectiveness of the package of interventions proposed for the SM-2015. The success of this design rests on the political commitment of countries and donors.

Air pollution and heart rate variability among the elderly in Mexico City.

BACKGROUND: Suspended particles and ozone have been associated with varying degrees of cardiac autonomic dysfunction. METHODS: In Mexico City, residents from a nursing home underwent heart rate variability analysis every other day for 3 months. Indoor and outdoor PM2.5 (particulate matter less than 2.5 mm in diameter) were measured daily at the nursing home. Levels of ozone and other atmospheric pollutants were obtained from a nearby automated monitoring station. RESULTS: Of the initial 42 screened participants, 34 (81%) were followed during the study period. The 24-hour average levels of indoor PM2.5 ranged from 15 to 67 micro g/m3, and outdoor PM2.5 ranged from 9 to 87 micro g/m3. Daily 1-hour maximum ozone levels ranged from 47 to 228 ppb. After adjusting for age and heart rate, we observed a strong decrease in the high frequency component of heart rate variability and the average 24-hour concentrations of PM2.5. Participants with hypertension had considerably larger reductions in their HF-HRV (high frequency-heart rate variability) component in relation to both ozone and PM2.5 exposure. CONCLUSIONS: Our results suggest that ambient levels of PM2.5 and ozone can reduce the high-frequency component of heart rate variability in elderly subjects living in Mexico City and that subjects with underlying hypertension are particularly susceptible to this effect.

Gene therapy with galectin-3 inhibits bronchial obstruction and inflammation in antigen-challenged rats through interleukin-5 gene downregulation.

The pathophysiology of asthma involves an intricate network of molecular and cellular interactions. Elevated Th2 cytokines (interleukin [IL]-5 and IL-4) associated with eosinophilic inflammation characterize allergic diseases and provide potential targets for immunomodulation. Recent evidence has demonstrated that galectin-3 induces selective downregulation of IL-5 gene expression in several cell types (eosinophils, T cell lines, and antigen specific T cells). Accordingly, we sought to elucidate whether in vivo intratracheal instillation of plasmid DNA encoding galectin-3 would inhibit an experimental asthmatic reaction in a rat model with increased eosinophils and T cells in bronchoalveolar fluid and impaired pulmonary function. We found that instillation of galectin-3 gene in these rats led to normalization of the eosinophil and T cell count in bronchoalveolar lavage fluid and that there was a strong concomitant inhibition of IL-5 mRNA in the lungs. As a consequence, galectin-3-treated rats showed recovery of pulmonary functional parameters, such as pulmonary pressure and expiratory flows. These data emphasize the potential utility of galectin-3 as a novel therapeutic approach for treatment of allergic asthma.