Intensifying spatially compound heatwaves: Global implications to crop production and human population.

Recent research has provided crucial insights on regional heatwaves, including their causal mechanisms and changes under global warming. However, detailed research on global-scale spatially compound heatwaves (SCHs) (concurrent heatwaves over multiple regions) is lacking. Here, we find statistically significant teleconnections in heatwaves and show that the frequency of global-scale SCHs and their areal extent have increased significantly, which has led to 50 % increase in the population exposed to extreme heat stresses in the two most recent decades. Crop yields were reduced in most of the years of anomalous heatwaves, which often happen during El-Niños. The internal climate variability appears to significantly influence the inter-annual variability of regional and global heatwave extents. Insights gained here are critical in better quantifying heat stress risks inflicted on socioecological systems.

Soil greenhouse gas emissions from dead and natural mangrove forests in Southeastern Brazil.

Mangroves forests may be important sinks of carbon in coastal areas but upon their death, these forests may become net sources of carbon dioxide (CO2) and methane (CH4) to the atmosphere. Here we assessed the spatial and temporal variability in soil CO2 and CH4 fluxes from dead mangrove forests and paired intact sites in SE-Brazil. Our findings demonstrated that during warmer and drier conditions, CO2 soil flux was 183 % higher in live mangrove forests when compared to the dead mangrove forests. Soil CH4 emissions in live forests were > 1.4-fold higher than the global mangrove average. During the wet season, soil GHG emissions dropped significantly at all sites. During warmer conditions, mangroves were net sources of GHG, with a potential warming effect (GWP100) of 32.9 ± 10.2 (±SE) Mg CO2e ha-1 y-1. Overall, we found that dead mangroves did not release great amounts of GHG after three years of forest loss.

Dynamics of dissolved inorganic carbon (DIC) and stable C isotope ratios (δ13CDIC) in a tropical watershed with diversified land use in São Paulo State, Brazil.

The fluvial transport of dissolved inorganic carbon (DIC) is an important component of the global carbon cycle. Herein, we assessed the dynamics of DIC and the C stable isotopic composition (δ13CDIC) in a watershed with diversified land use in São Paulo State (Brazil), more specifically in the Sorocaba River basin (SRB) and considered the temporal and spatial scales. For this purpose, twelve fluvial samples at each sampling point (e.g., S1, S2, S3, S4 and S5) were collected in the SRB, from June 2009 to May 2010, which represented one complete hydrological cycle that included the extremes of the rainfall and discharge regimes. In addition, the δ13CDIC values were also characterized in the wet and dry season at all sampling points to verify their seasonal variability. The results reflected the seasonal variation in discharges, water temperatures, and electrical conductivities. Most of the DIC was transported in the wet season at all sampling points, where the less negative δ13CDIC values were characterized. The natural sources of DIC are associated with atmospheric/soil CO2 consumption. The anthropogenic impacts on both [DIC] and δ13CDIC are linked to untreated urban sewage that is discharged directly into the Sorocaba River, as well as to aquatic photosynthesis in the Itupararanga Reservoir. From 1970 to 2020, the modeling proposed in this study indicated that the annual flux of DIC (Friver) varied from 9.0 to 78.7 t km-2 a-1, confirming that the El Niño Southern Oscillation (ENSO) controlled Friver in the SRB, with higher and lower Friver values occurring during strong El Niño (EN) and La Niña (LN) years. The average Friver value was 20 t km-2 a-1, which is higher than those obtained in natural several temperate and tropical watersheds due to the influences of urban areas on [DIC] in the SRB.

Complicaciones y descargas inapropiadas tras el implante de un desfibrilador subcutáneo en pacientes pediátricos / Complications and inappropriate shocks in pediatric patients receiving a subcutaneous implantable cardioverter defibrilator

Introducción y objetivos: La experiencia con el desfibrilador automático implantable subcutáneo (DAI-SC) en pacientes pediátricos aún es reducida. El objetivo de este estudio es determinar la incidencia de complicaciones en pacientes pediátricos de nuestro centro en función del tipo de DAI y del tamaño del paciente.MétodosSe incluyó a pacientes menores de 18 años que recibieron un DAI-SC desde 2016 y pacientes contemporáneos (desde 2014) que recibieron un DAI transvenoso (DAI-TV). El evento principal fue el combinado de complicaciones y descargas inapropiadas.ResultadosSe implantó un DAI-SC a 26 pacientes (edad, 14 [intervalo, 5-17] años; índice de masa corporal [IMC], 20,2). De ellos, 23 (88%) fueron implantes intermusculares y el resto, en subserrato, 24 (92%) con 2 incisiones. Se programaron 2 zonas en todos los pacientes: condicional a 230 (220-230) lpm y de choque a 250 lpm. El grupo de DAI-TV incluyó a 19 pacientes (edad, 11 [5-16] años; IMC, 19,2; el 79% monocamerales). La supervivencia libre del evento principal a 5 años fue el 80% de los pacientes con DAI-SC y el 63% del grupo con DAI-TV (p=0,54); la de descargas inapropiadas fue similar (el 85 frente al 89%; p=0,86), mientras que la de complicaciones fue mayor en el grupo de DAI-SC (el 96 frente al 57%; cloglog p=0.016). En el grupo de DAI-SC no hubo fallo de la terapia ni mayores complicaciones con un IMC ≤ 20.ConclusionesCon las técnicas de implante y programación actuales, el DAI-SC es eficaz y seguro en pacientes pediátricos, con similares descargas inapropiadas y menos complicaciones a corto y medio plazo que el DAI-TV. (AU)

Introduction and objectives: There is limited evidence regarding the use of subcutaneous implantable cardioverter-defibrillators (S-ICD) in pediatric patients. The aim of this study was to determine the incidence of complications in these patients at our center, according to the type of ICD and patient size.MethodsWe included all patients aged<18 years who received an S-ICD since 2016 at our center. As a control group, we also included contemporary patients (since 2014) who received a transvenous ICD (TV-ICD). The primary endpoint was a composite of complications and inappropriate shocks.ResultsA total of 26 patients received an S-ICD (median age, 14 [5-17] years; body mass index [BMI], 20.2 kg/m2). Implantation was intermuscular in 23 patients (88%) and subserratus in the remainder. Two incisions were used in 24 patients (92%). In all patients, 2 zones were programmed: a conditional zone set at 230 (220-230) bpm, and a shock zone set at 250 bpm. Nineteen patients received a TV-ICD (median age, 11 [range, 5-16] years; BMI, 19.2 kg/m2, 79% single-chamber). Survival free from the primary endpoint at 5 years was 80% in the S-ICD group and 63% in the TV-ICD group (P=.54). Survival free from inappropriate shocks was similar (85% vs 89%, P=.86), while survival free from complications was higher in the S-ICD group (96% vs 57%, cloglogP=.016). There were no therapy failures in the S-ICD group, and no increased complication rates were observed in patients with BMI ≤ 20 kg/m2.ConclusionsWith contemporary implantation techniques and programming, S-ICD is a safe and effective therapy in pediatric patients. The number of inappropriate shocks is similar to TV-ICD, with fewer short- and mid-term complications. (AU)

Eventos adversos em crianças submetidas a cirurgias orofaciais / Adverse events in children submitted to orofacial surgery / Eventos adversos en niños sometidos a cirugía orofacial

Objetivo: Identificar os eventos adversos no pós-operatório imediato de queiloplastia e/ou palatoplastia em crianças e comparar os eventos identificados aos notificados ao Núcleo de Segurança do Paciente. Métodos: Estudo descritivo, retrospectivo e quantitativo, realizado em um hospital público e terciário brasileiro. Os dados foram coletados por meio da descrição nos registros de enfermagem e comparados aos notificados ao Núcleo de Segurança do Paciente, referente a junho e dezembro de 2019. Os resultados foram submetidos a análise estatística descritiva. Resultados: A amostra constou de 203 crianças, das quais 51% (n=103) apresentaram evento adverso. Foram identificados 176 eventos adversos, de 8 tipos, com prevalência da laringite pós-extubação (n=50; 28%), edema de língua (n=34; 19%) e lesão de comissura labial (n=25; 14%). Destes, apenas 5% (n=9) foram notificados ao Núcleo de Segurança do Paciente. Conclusão: Os eventos adversos prevalentes se relacionaram a cavidade oral e tecidos adjacentes, e a subnotificação foi expressiva. (AU)

Objective: To identify adverse events in the immediate postoperative period of cheiloplasty and/or palatoplasty in children and compare the identified events to those notified to the Patient Safety Center. Methods: Descriptive, retrospective and quantitative study, carried out in a Brazilian public and tertiary hospital. Data were collected through descriptions in nursing records and compared to those notified to the Patient Safety Center, referring to June and December 2019. The results were subjected to descriptive statistical analysis. Results: The sample consisted of 203 children, of which 51% (n=103) had an adverse event. A total of 176 adverse events of 8 types were identified, with prevalence of post-extubation laryngitis (n=50; 28%), tongue edema (n=34; 19%) and labral commissure lesion (n=25; 14%). Of these, only 5% (n=9) were notified to the Patient Safety Center. Conclusion: The prevalent adverse events were related to the oral cavity and adjacent tissues, and underreporting was significant. (AU)

Objetivo: Identificar eventos adversos en el postoperatorio inmediato de queiloplastia y/o palatoplastia en niños y comparar los eventos identificados con los notificados al Centro de Seguridad del Paciente. Métodos: Estudio descriptivo, retrospectivo y cuantitativo, realizado en un hospital público y terciario brasileño. Los datos se recolectaron mediante descripciones en registros de enfermería y se compararon con los notificados al Centro de Seguridad del Paciente, referidos a junio y diciembre de 2019. Los resultados fueron sometidos a análisis estadístico descriptivo. Resultados: La muestra estuvo conformada por 203 niños, de los cuales el 51% (n = 103) tuvo un evento adverso. Se identificaron un total de 176 eventos adversos de 8 tipos, con prevalencia de laringitis posextubación (n=50; 28%), edema de lengua (n=34; 19%) y lesión de la comisura del labrum (n=25; 14%). De estos, solo el 5% (n=9) fueron notificados al Centro de Seguridad del Paciente. Conclusion: Los eventos adversos prevalentes se relacionaron con la cavidad bucal y los tejidos adyacentes y el subregistro fue significativo. (AU)

Diferencias en la evolución del sobrepeso y la obesidad infantil en España en el periodo 2011-2019 por sexo, edad y nivel socioeconómico: resultados del estudio ALADINO / Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: Results of the ALADINO study

Introducción: El exceso de peso infantil es un problema de salud pública creciente. El objetivo del trabajo es estudiar la evolución de la prevalencia de sobrepeso, de obesidad y de obesidad central en escolares de 6 a 9años en España entre 2011 y 2019 según características demográficas y socioeconómicas.MetodologíaSe incluyeron las rondas 2011, 2015 y 2019 del estudio observacional, descriptivo y transversal ALADINO en escolares de ambos sexos de 6 a 9años. Se realizó un análisis descriptivo de la evolución de la prevalencia de sobrepeso y de obesidad según los criterios de la Organización Mundial de la Salud (OMS) y la International Obesity Task Force (IOTF), así como obesidad central, y las variables demográficas y socioeconómicas asociadas.ResultadosEntre 2011 y 2019 se redujo la prevalencia de sobrepeso (criterios OMS) en niños de 6, 7 y 8años (−5,4, −5,7 y −5,3 puntos porcentuales, respectivamente) y niños cuyos progenitores tenían estudios superiores (−5,3 puntos porcentuales). Por renta, el sobrepeso en niños se redujo en todos los niveles de ingresos. Sin embargo, entre 2011 y 2019 se mantuvieron estables tanto la prevalencia de sobrepeso en niñas como la prevalencia de obesidad según las referencias OMS e IOTF y la de obesidad central en ambos sexos.ConclusionesLas prevalencias de sobrepeso y de obesidad en escolares de 6 a 9años en España siguen siendo altas. Entre 2011 y 2019 disminuyó la prevalencia de sobrepeso en niños de 6 a 8años y aquellos cuyos progenitores tienen estudios universitarios, mientras que la obesidad en niños, el sobrepeso y la obesidad en niñas, y la obesidad central en ambos sexos han permanecido estables. (AU)

Introduction: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6 to 9years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics.MethodologyThe analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6 to 9years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization [WHO] and the International Obesity Task Force [IOTF]) and of central obesity, in addition to associated demographic and socioeconomic variables.ResultsBetween 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8years (by −5.4%, −5.7% and −5.3%, respectively) and boys whose parents had a higher educational attainment (by −5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable.ConclusionsThe prevalence of overweight and the prevalence of obesity in schoolchildren aged 6 to 9years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6 to 8years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable. (AU)

Validación de una escala enfermera para evaluar las actitudes del profesorado en la atención diabética / Validation of a nursing scale for assessing teachers' attitudes to diabetes care

Objetivo: Validar el Inventario de Actitudes Negativas del Profesorado hacia la Atención del Alumnado con Diabetes Mellitus tipo 1 (INAPAD) y estudiar su fiabilidad mediante los coeficientes Alfa de Cronbach y Omega de McDonald. Material y método: Este estudio describe el proceso de diseño y validación de la escala enfermera INAPAD en una muestra de 382 docentes en las etapas de Educación Infantil, Educación Primaria, Educación Secundaria Obligatoria, Bachillerato y Formación Profesional en una provincia española. El INAPAD pretende valorar diversas dimensiones actitudinales sobre la atención educativa al alumnado con Diabetes Mellitus tipo 1, incidiendo tanto en el perfil docente y profesional del profesorado, como en las características y necesidades específicas de este alumnado. Por su parte, la validez de constructo se ha evaluado mediante análisis factoriales exploratorios por componentes principales y rotación varimax. Resultados y Conclusión: Los resultados obtenidos informan de la viabilidad del INAPAD para ser utilizado como un instrumento útil para el diagnóstico del prejuicio o predisposición del profesorado hacia la atención del alumnado con DM tipo 1 y, por ende, para predecir el éxito de las medidas psicopedagógicas y los cuidados del niño y adolescente con diabetes. (AU)

Objective: To validate the Inventory of Teachers' Negative Attitudes towards the Care of Students with Diabetes Mellitus type 1 (INAPAD) and to study its reliability using Cronbach's Alpha and McDonald's Omega coefficients. Enfermería GlobalNº 74 Abril 2024Página 195Methods: This study describes the design and validation process of the INAPAD nursing scale in a sample of 382 teachers in the stages of Early Childhood Education, Primary Education, Compulsory Secondary Education, Baccalaureate and Vocational Training in a Spanish province. In order to validate the INAPAD, its reliability has been studied using Cronbach's Alpha and McDonald's Omega Coefficients. Hence, the construct validity has been evaluated through exploratory factor analysis by principal components and varimax rotation. Results and conclusion: The findings obtained inform the viability of the INAPAD to be used as an effective instrument for the diagnosis of prejudice or predisposition of educators towards the care of learners with type 1 DM and for the prediction of the success of psycho-pedagogical measures and of the care for children and adolescents with diabetes. (AU)

Relación entre la dieta, aspectos nutricionales y la calidad del sueño en población pediátrica / Relationship between diet, nutritional aspects and sleep quality in a pediatric population

La relación entre la dieta y el sueño ha sido escasamente estudiada en la población pediátrica. El objetivo de esta revisión fue analizar de forma narrativa la relación existente entre la dieta, determinados aspectos nutricionales y la calidad del sueño en esta población. Se seleccionaron estudios que midieran la dieta y valorasen el estado nutricional y el sueño en población infantil mediante la utilización de distintas herramientas. El riesgo de sesgo de los 14 estudios seleccionados se determinó con herramientas validadas. La adhesión a algunos patrones dietéticos como el mediterráneo, el alto consumo de frutas y verduras, la ingesta de triptófano o la sustitución de los ácidos grasos saturados por grasas insaturadas se relacionaron con una mejor calidad del sueño. El consumo de los productos ultraprocesados y la ingesta alta de azúcares simples dificultan un descanso adecuado. Por otro lado, se observó una asociación entre un índice de masa corporal alto y la falta de sueño en los jóvenes menores de 14 años. En conclusión, los estudios recogidos mostraron una asociación significativa entre algunos patrones dietéticos, grupos de alimentos y nutrientes con la calidad del sueño. Los factores dietéticos “poco saludables” se asociaron a una peor calidad del sueño. Sin embargo, hábitos y dietas más saludables y recomendados se relacionaron con una mejora de la higiene del sueño. Por otro lado, la falta de horas de descanso en la población juvenil se relaciona con el aumento de peso.(AU)

The relationship between diet and sleep has been studied in adults. However, there is little evidence in the pediatric population. The objective of this review was to analyze in a narrative way the relationship between diet, some nutritional aspects and sleep quality in population under 14 years. A quick review was performed in MEDLINE (PubMed) and Cochrane with a search strategy combining MeSH terms and keywords. Studies were selected to estimate diet and evaluate nutritional status and sleep in children using different tools. The risk of bias from the 14 selected studies was determined with validated tools (AMSTAR 2, Newcastle Ottawa scale [NOS] and Risk of Bias [Rob2]). Adherence to some dietary patterns such as the Mediterranean, high consumption of fruits and vegetables, tryptophan intake or substitution of saturated fatty acids by unsaturated fats were associated with better sleep quality. The consumption of ultra-processed products, the “unhealthy fast food” or the high intake of simple sugars hinder an adequate rest. On the other hand, an association between a high body mass index and lack of sleep was observed in young people under 14. In conclusion, the collected studies showed a significant association between some dietary patterns, food groups and nutrients with sleep quality. “Unhealthy” dietary factors were associated with poorer sleep quality. However, healthier and recommended habits and diets were associated with improved sleep hygiene. On the other hand, the lack of hours of rest in the youth population increases height, weight and BMI. Further research is needed in this direction.(AU)

Dominant contribution of atmospheric nonlinearities to ENSO asymmetry and extreme El Niño events.

Extreme El Niño events have outsized impacts and strongly contribute to the El Niño Southern Oscillation (ENSO) warm/cold phase asymmetries. There is currently no consensus on the respective importance of oceanic and atmospheric nonlinearities for those asymmetries. Here, we use atmospheric and oceanic general circulation models that reproduce ENSO asymmetries well to quantify the atmospheric nonlinearities contribution. The linear and nonlinear components of the wind stress response to Sea Surface Temperature (SST) anomalies are isolated using ensemble atmospheric experiments, and used to force oceanic experiments. The wind stress-SST nonlinearity is dominated by the deep atmospheric convective response to SST. This wind-stress nonlinearity contributes to ~ 40% of the peak amplitude of extreme El Niño events and ~ 55% of the prolonged eastern Pacific warming they generate until the following summer. This large contribution arises because nonlinearities consistently drive equatorial westerly anomalies, while the larger linear component is made less efficient by easterly anomalies in the western Pacific during fall and winter. Overall, wind-stress nonlinearities fully account for the eastern Pacific positive ENSO skewness. Our findings underscore the pivotal role of atmospheric nonlinearities in shaping extreme El Niño events and, more generally, ENSO asymmetry.

Asociación entre los marcadores lipídicos en la infancia/ adolescencia y los eventos cardiovasculares en la adultez: una revisión sistemática / Association between lipid markers in childhood/ adolescence and cardiovascular events in adulthood: A systematic review

Introducción. La asociación entre los marcadores lipídicos en la infancia/adolescencia y la incidencia de eventos clínicos cardiovasculares en la adultez está poco explorada en la literatura. El objetivo de esta revisión sistemática fue analizar la evidencia disponible sobre este tema. Población y métodos. Esta revisión sistemática se realizó de acuerdo con las guías PRISMA. Se realizó una búsqueda bibliográfica para detectar los estudios que evaluaron la asociación entre los niveles lipídicos en la edad pediátrica y la incidencia de eventos cardiovasculares en la edad adulta. No hubo restricciones idiomáticas ni geográficas en la búsqueda. Resultados. En total, cinco estudios observacionales (todas cohortes prospectivas) que incluyeron 43 540 pacientes fueron identificados y considerados elegibles para este estudio. Cuatro estudios evaluaron el nivel de triglicéridos; todos reportaron una asociación significativa entre este marcador en la edad pediátrica y los eventos cardiovasculares en la adultez. Un estudio reportó la misma asociación con el nivel de colesterol total, mientras que otro evidenció el valor predictivo de la lipoproteína (a) para el mismo desenlace clínico. Un solo estudio evaluó el colesterol asociado a lipoproteínas de alta densidad (C-HDL), sin encontrar una relación con el punto final de interés. El análisis del colesterol asociado a lipoproteínas de baja densidad (C-LDL) arrojó resultados contradictorios, aunque la asociación fue significativa en los estudios con un tamaño muestral más grande y con un mayor número de eventos durante el seguimiento. Conclusión. Los datos de esta revisión sugieren que las alteraciones de los marcadores lipídicos en la infancia y la adolescencia se asocian con un mayor riesgo cardiovascular en la adultez temprana y media.

Introduction. The association between lipid markers in childhood/adolescence and the incidence of clinical cardiovascular events in adulthood has been little explored in the bibliography. The objective of this systematic review was to analyze available evidence on this topic. Population and methods. This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive bibliographic search was done to find studies assessing the association between lipid levels in childhood and the incidence of cardiovascular events in adulthood. There were no language or geographic restrictions. Results. A total of 5 observational studies (all prospective cohorts) including 43 540 patients were identified and considered eligible for this study. Four studies assessed triglyceride levels; all reported a significant association between this lipid marker in childhood and cardiovascular events in adulthood. A study reported the same association with total cholesterol level, while another showed the predictive value of lipoprotein (a) for the same clinical outcome. Only one study assessed high-density lipoprotein cholesterol (HDL-C), but it did not find an association with the endpoint of interest. The analysis of lowdensity lipoprotein cholesterol (LDL-C) showed contradictory results, although the association was significant in the studies with a larger sample size and a higher number of events during follow-up. Conclusion. According to this review, alterations in lipid markers in childhood and adolescence are associated with a higher cardiovascular risk in early and middle adulthood.

Versión argentina de la herramienta de evaluación de la alimentación pediátrica PediEAT / Argentine version of the PediEAT, a pediatric eating assessment tool

Introducción. Durante la infancia, los niños pueden experimentar algún grado de dificultad al comer. Existe una herramienta, desarrollada en Estados Unidos, de evaluación de la alimentación pediátrica (PediEAT), que permite identificar síntomas problemáticos. Objetivo. Realizar una adaptación transcultural para una versión argentina, con adecuación cultural y equivalencia semántica respecto a su versión original. Población y métodos. Se utilizó una versión autoadministrada del PediEAT que fue respondida por familias y/o cuidadores de niños de 6 meses a 7 años. Se realizó una primera fase de evaluación de validez del contenido con un grupo de expertos. Luego, una fase de pretest con familias mediante entrevistas cognitivas para comprobar la comprensión de las palabras y frases. Se realizaron las modificaciones necesarias para que quedara adaptada al contexto. Resultados. En la fase de evaluación de validez del contenido con el grupo de 8 expertos, de los 80 ítems se modificaron 36. En el pretest, se realizaron entrevistas cognitivas a 18 cuidadores; se realizaron cambios en 11 ítems para mejorar la comprensión por parte de la población argentina. La versión argentina fue aprobada por los autores originales. Conclusiones. El instrumento PediEAT versión argentina resulta lingüísticamente equivalente a su versión original, lo que permite su uso para la detección de problemáticas alimentarias en niños.

Introduction. During childhood, children may experience some degree of difficulty eating. A tool (PediEAT) has been developed in the United States and is available to assess pediatric eating and to identify problematic symptoms. Objective. To obtain an Argentine version that is transculturally adapted, culturally adequate, and semantically equivalent to the original version. Population and methods. A self-administered version of the PediEAT was used and completed by families and/or caregivers of children aged 6 months to 7 years. In the first phase, content validity was assessed by a group of experts. This was followed by a pre-test phase with families using cognitive interviews to test word and phrase comprehension. The necessary changes were made to obtain a version adapted to the context. Results. The tool's content validity was assessed by a group of 8 experts; as a result, 36 of the 80 items were changed. During the pre-test phase, cognitive interviews were conducted with 18 caregivers; 11 items were changed to improve comprehension by the Argentine population. The Argentine version was approved by the original authors. Conclusions. The Argentine version of the PediEAT tool is linguistically equivalent to the original version, and this allows its use to screen for feeding problems in children.

A prática psicológica e a ludicidade na hospitalização pediátrica: relato de experiência / Psychological practice and playing in pediatric hospitalization: experience report / La práctica psicológica y la ludicidad en la hospitalización pediátrica: informe de experiencia

INTRODUÇÃO: A inserção da psicologia e o método lúdico de intervenção na esfera hospitalar surge para promover bem-estar frente às vivências das crianças em condição de internação. O enfrentamento de uma hospitalização no período da infância pode provocar impactos significativos do ponto de vista orgânico, psíquico e ambiental, por ser um momento de estruturação do indivíduo enquanto sujeito psíquico. OBJETIVO: Posto isso, o presente artigo objetiva refletir sobre a relação da família e da equipe de saúde com crianças hospitalizadas e a relevância da utilização dos recursos lúdicos, a partir de um relato de experiência de estagiários de um curso de graduação em psicologia. MÉTODO: Logo, trata-se de um relato de experiência, de abordagem qualitativa e de natureza descritiva, realizado de março de 2022 a junho de 2023, em uma Unidade Pediátrica de um Hospital Público Brasileiro. RESULTADOS E DISCUSSÃO: A partir disso, observaram-se na prática reações de estranhamento dos pacientes ao se depararem com a permanência no hospital, o adoecimento e os procedimentos das equipes multiprofissionais de saúde; bem como evidenciou-se a importância da transmissão das informações e do preparo verbal ante intervenções, visando a participação ativa do paciente em seu tratamento. Também observou-se a significância do uso de ferramentas lúdicas nas intervenções com as crianças, que facilitam a adaptação ao contexto e proporcionam âncora para estas elaborarem suas vivências. CONCLUSÃO: Portanto, conclui-se que a utilização de recursos lúdicos favorece o atendimento psicológico na infância e período de hospitalização.

INTRODUCTION: The integration of psychology and the playing method of intervention in the hospital setting emerges to promote wellbeing in the face of children's experiences during hospitalization. Confronting hospitalization during childhood can lead to significant impacts from organic, psychological, and environmental standpoints, as it represents a pivotal moment in the individual's psychological development. OBJECTIVE: With this in mind, the present article aims to reflect on the relationship between families and healthcare teams with hospitalized children and the relevance of using playful resources, based on an experience report from interns of an undergraduate psychology course. METHOD: Therefore, it constitutes an experiential account, employing a qualitative and descriptive approach, conducted from March 2022 to June 2023, in a Pediatric Unit of a Brazilian Public Hospital. RESULTS AND DISCUSSION: From this perspective, practical observations revealed patients' feelings of unfamiliarity upon facing hospital stays, illness, and procedures performed by multidisciplinary healthcare teams; as well as the significance of conveying information and verbal preparation before interventions was highlighted, aiming to actively involve the patient in their treatment. It was also observed the significance of using playful tools in interventions with children, which facilitates adaptation to the context and provides an anchor for them to elaborate on their experiences. CONCLUSION: Thus, it can be concluded that the use of playful resources enhances psychological care during childhood and the hospitalization period.

INTRODUCCIÓN: La inserción de la psicología y el método lúdico de intervención en el ámbito hospitalario surge con el propósito de promover el bienestar frente a las experiencias de los niños en condiciones de hospitalización. Enfrentar la hospitalización durante la infancia puede generar impactos significativos desde un punto de vista orgánico, psicológico y ambiental, ya que representa un momento de estructuración del individuo como sujeto psíquico. OBJETIVO: En este sentido, el presente artículo tiene como objetivo reflexionar sobre la relación de la familia y el equipo de salud con niños hospitalizados y la relevancia de utilizar recursos lúdicos, a partir de un relato de experiencia de practicantes de un curso de grado en psicología. MÉTODO: Por lo tanto, se trata de un informe de experiencia con enfoque cualitativo y de naturaleza descriptiva, llevado a cabo desde marzo de 2022 hasta junio de 2023 en una Unidad Pediátrica de un Hospital Público Brasileño. RESULTADOS Y DISCUSIÓN: A partir de esto, se observaron reacciones de desconcierto por parte de los pacientes al enfrentar la permanencia en el hospital, la enfermedad y los procedimientos realizados por los equipos de salud multidisciplinarios; así como también se resaltó la importancia de la transmisión de información y la preparación verbal antes de las intervenciones, con el objetivo de involucrar activamente al paciente en su tratamiento. También se observó la importancia del uso de herramientas lúdicas en las intervenciones con niños, ya que facilitan la adaptación al contexto y brindan un punto de referencia para que estos niños elaboren sus experiencias. CONCLUSIÓN: Por lo tanto, se concluye que el uso de recursos lúdicos favorece la atención psicológica durante la infancia y el período de hospitalización.

Análisis de meriendas escolares: estudio piloto en educación infantil / School meals analysis: pilot study in early childhood education

Fundamentos: La escuela puede ser un contexto favorecedor para prevenir la obesidad infantil, por lo que pautar meriendas escolares puede contribuir a adoptar hábitos saludables. El objetivo de este estudio fue doble: a) analizar el grado de cumplimiento de las meriendas pautadas; b) comparar las características de las meriendas según si eran o no pautadas. Métodos: Estudio transversal donde han participado centros escolares de las ciudades de Vigo y Pontevedra. Para el análisis comparativo se clasificó y categorizó cada una de las meriendas de los centros con y sin pauta. Asimismo, se comparó la composición de las meriendas establecidas, dependiendo si habían cumplido o no la pauta. Resultados: Se analizaron 1259 meriendas establecidas y 1363 sin pauta. El 81,2% de las meriendas recogidas cumplían con los requisitos pautados. Las meriendas no establecidas incluyeron un número de alimentos significativamente superior (p<0,001), así como un mayor porcentaje de alimentos ultraprocesados. En los centros con pauta, los niños cumplidores incluían más fruta y embutido, mientras que los no cumplidores llevaban más ultraprocesados. Conclusiones: Pautar meriendas escolares en educación infantil es una estrategia efectiva para asegurar una nutrición variada y una menor ingesta de alimentos ultraprocesados. (AU)

Background: The school can be a favorable context to prevent childhood obesity, so that the pattern of school snacks can contribute to the adoption of healthy habits. The aim of this study was twofold: a) to analyze the degree of compliance with the prescribed snacks; b) to compare the characteristics of the snacks according to whether they were prescribed or not. Methods: Cross-sectional study in which schools in the cities of Vigo and Pontevedra participated. For the comparative analysis, we classified and categorized each of the snacks in the schools with and without guidelines. Likewise, the composition of the established snacks was compared, depending on whether or not they had complied with the guideline. Results: A total of 1259 established snacks and 1363 without guidelines were analyzed. Of the snacks collected, 81.2% complied with the requirements established. The non-established snacks included a significantly higher number of foods (p<0.001), as well as a higher percentage of ultra-processed foods. In guideline centers, compliant children included more fruit and sausage, while non-compliant children had more ultra-processed foods. Conclusions: The school snack program in early childhood education is an effective strategy to ensure avaried nutrition and a lower intake of ultra-processed foods. (AU)

Climate change reduces long-term population benefits from no-take marine protected areas through selective pressures on species movement.

Marine protected areas (MPAs) are important conservation tools that confer ecosystem benefits by removing fishing within their borders to allow stocks to rebuild. Fishing mortality outside a traditionally fixed MPA can exert selective pressure for low movement alleles, resulting in enhanced protection. While evolving to move less may be useful for conservation presently, it could be detrimental in the face of climate change for species that need to move to track their thermal optimum. Here, we build a spatially explicit simulation model to assess the impact of movement evolution in and around static MPAs resulting from both fishing mortality and temperature-dependent natural mortality on conservation benefits across five climate scenarios: (i) linear mean temperature shift, (ii) El Niño/La Niña conditions, (iii) heat waves, (iv) heatwaves with a mean temperature shift, and (v) no climate change. While movement evolution allows populations within MPAs to survive longer, we find that over time, climate change degrades the benefits by selecting for higher movement genotypes. Resulting population declines within MPAs are faster than expected based on climate mortality alone, even within the largest MPAs. Our findings suggest that while static MPAs may conserve species for a time, other strategies, such as dynamic MPA networks or assisted migration, may also be required to effectively incorporate climate change into conservation planning.

Investigation of the Correlation between Enterovirus Infection and the Climate Factor Complex Including the Ping-Year Factor and El Niño-Southern Oscillation in Taiwan.

Enterovirus infection and enterovirus infection with severe complications (EVSC) are critical issues in several aspects. However, there is no suitable predictive tool for these infections. A climate factor complex (CFC) containing several climate factors could provide more effective predictions. The ping-year factor (PYF) and El Niño-Southern Oscillation (ENSO) are possible CFCs. This study aimed to determine the relationship between these two CFCs and the incidence of enterovirus infection. Children aged 15 years and younger with enterovirus infection and/or EVSC were enrolled between 2007 and 2022. Each year was categorized into a ping-year or non-ping-year according to the PYF. Poisson regression was used to evaluate the associations between the PYF, ENSO, and the incidence of enterovirus infection. Compared to the ping-year group, the incidence rate of enterovirus infection, the incidence rate of EVSC, and the ratio of EVSC in the non-ping-year group were 1.24, 3.38, and 2.73 times higher, respectively (p < 0.001). For every one-unit increase in La Niña, the incidence rate of enterovirus infection decreased to 0.96 times (p < 0.001). Our study indicated that CFCs could be potential predictors for enterovirus infection, and the PYF was more suitable than ENSO. Further research is needed to improve the predictive model.

Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: results of the ALADINO study.

INTRODUCTION: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6-9 years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics. METHODOLOGY: The analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6-9 years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization and the International Obesity Task Force) and of central obesity, in addition to associated demographic and socioeconomic variables. RESULTS: Between 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8 years (by -5.4%, -5.7% and -5.3%, respectively) and boys whose parents had a higher educational attainment (by -5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable. CONCLUSIONS: The prevalence of overweight and the prevalence of obesity in schoolchildren aged 6-9 years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6-8 years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable.

Alcohol use among children and adolescents with chronic pain. Scoping review.

AIM: To examine and map alcohol consumption in children and adolescents with chronic pain (CP). METHOD: A scoping review of international databases (CINAHL, WOS, PubMed, PsycINFO, Scopus, Embase, and MEDLINE) and grey literature was conducted between September 2022 and February 2023. Documents addressing the relationship between alcohol consumption and CP in children and adolescents, published in English and Spanish between 2012 and 2023, were included. Those papers with a population suffering from CP derived from neurodegenerative diseases, chronic infectious diseases or cognitive impairment were excluded. We assessed the level of evidence (LE) and the degree of recommendation (DR) of the studies included in accordance with the Scottish Intercollegiate Guidelines Network. Finally, 11 documents were considered out of the 479 reviewed. RESULTS: The relationship between substance consumption and CP in adolescents is a scarcely investigated topic. While there is a trend towards lower rates of alcohol consumption in youth with pain, there is evidence suggesting an association, particularly in cases of intense pain. The use of various substances, both legal and illegal, for pain management underscores the importance of comprehensively addressing this phenomenon in this population. CONCLUSIONS: Further research is needed to assess the relationship between alcohol consumption in children and adolescents with CP.

Síndrome de pseudotumor cerebri en la población pediátrica: características clínicas, tratamiento y pronóstico / Pseudotumor cerebri in the paediatric population: clinical features, treatment and prognosis

Introducción El síndrome de pseudotumor cerebri (SPTC) en pacientes prepuberales presenta características que lo diferencian respecto a su presentación en la etapa pospuberal. Nuestro objetivo es describir las características de los pacientes diagnosticados de SPTC pediátrico en nuestro centro y compararlas en función de su estado puberal. Pacientes y métodos Se incluyeron a los pacientes diagnosticados de SPTC en un hospital de tercer nivel entre los años 2006 y 2019 con edades comprendidas entre uno y 18 años que cumplieran los criterios diagnósticos actualizados del SPTC. Se clasificaron en función de su estado puberal y peso corporal. Posteriormente, se analizaron los datos de las punciones lumbares, estudios de neuroimagen, valoraciones oftalmológicas, así como el régimen terapéutico recibido a lo largo de su seguimiento. Resultados Se recogieron 28 pacientes, 22 prepuberales y seis pospuberales, con edad media de 9,04 ± 2,86 años. El 83,3% de los pacientes pospuberales eran varones presentando sobrepeso/obesidad en el 66,7%. Eran varones el 27% de los pacientes prepuberales, de ellos asociaban sobrepeso el 31,8%. La sintomatología más frecuente fue cefalea (89,9%) y visión borrosa (42,9%). Todos los pacientes presentaron papiledema; un 21,4% de los casos presentaron parálisis del VI par. Se identificó un posible desencadenante en un 28,6%. El 19% presentaron recurrencia clínica, siendo todos ellos prepuberales. La resolución clínica completa se produjo en el 55,6% de los pacientes. Conclusión Pacientes con SPTC presentan menor prevalencia de obesidad en la etapa prepuberal, junto con un mayor porcentaje de etiologías secundarias y tasa de recurrencia que los pacientes pospuberales. (AU)

Introduction Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. Patients and methods We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. Results We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. Conclusion Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients. (AU)

Relación entre la conciencia de madres y padres sobre el abuso sexual y las habilidades de los niños para decir «no» / The relationship between parental awareness of sexual abuse and children's skills to say «no»

Introducción: El abuso sexual infantil es un problema social global y multidimensional que provoca resultados devastadores y permanentes en las relaciones psicológicas, emocionales, cognitivas, conductuales, físicas, sexuales e interpersonales. Este estudio examina la relación entre la capacidad de decir «no» y la conciencia de madres y padres sobre el abuso sexual en estudiantes de 4.° de primaria. Métodos: El estudio se realizó entre abril de 2022 y junio de 2022 en escuelas primarias de un distrito central provincial en el noreste de Turquía. La muestra del estudio estuvo formada por 310 alumnos de 4.° de primaria y sus madres y padres. Compilamos los datos del estudio con el Formulario de información personal, la Escala de capacidad para decir «no» para niños y la Escala de conciencia de abuso sexual para padres. Resultados: Hubo una correlación positiva débil (p˂0,05) entre las puntuaciones medias de conciencia de las madres sobre el abuso sexual y las puntuaciones medias de rechazo y resistencia de los niños, y una correlación positiva débil (p˂0,05) entre las puntuaciones medias de la conciencia de los padres sobre el abuso sexual y las puntuaciones medias de rechazo de los niños. Conclusión: A medida que aumentó la conciencia de las madres y los padres sobre los mitos y las enseñanzas sobre el abuso sexual y las acciones para combatir el abuso sexual, también aumentó la negativa de los niños. Se encontró que a medida que aumentaba la conciencia de los padres sobre las señales de abuso sexual, aumentaba la negativa de los niños.(AU)

Introduction: Child sexual abuse is a global and multidimensional social problem and causes devastating and permanent psychological, emotional, cognitive, behavioural, physical, sexual and interpersonal sequelae. This study examines the relationship between the ability to say «no» and parental awareness of sexual abuse in 4th grade primary school students. Methods: The study was conducted between April 2022 and June 2022 in primary schools in the central district of a province in north-eastern Turkey. The sample consisted of 310 students enrolled in 4th grade and their parents. We collected the data through a personal information form, the ability to say «no» scale for children and the sexual abuse awareness scale for parents. Results: There was a weak positive correlation between the mean maternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P˂.05), as well as a weak positive correlation between the mean paternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P˂.05). Conclusion: As mothers’ and fathers’ awareness of sexual abuse myths and of teachings and actions to combat sexual abuse increased, the refusal of children also increased. Also, as fathers’ awareness of the signs of sexual abuse increased, children's refusal increased.(AU)

Ludificación y neurorrehabilitación motora en niños y adolescentes: revisión sistemática / Gamification and neurological motor rehabilitation in children and adolescents: A systematic review

Introducción La ludificación consiste en emplear el juego en contextos no lúdicos. Su uso en la rehabilitación motora de patologías neurológicas está muy extendido, pero sobre todo en pacientes adultos. El objetivo de esta revisión fue describir el uso de la ludificación en los tratamientos de rehabilitación en niños y adolescentes con afectación neuromotora. Métodos Se realizó una revisión sistemática de ensayos clínicos en diferentes bases de datos: Medline (a través de Pubmed), Scielo, SCOPUS, Dialnet, Cinahl y PEDro de la literatura científica publicada hasta la fecha siguiendo el protocolo PRISMA. La calidad metodológica de los estudios identificados se evaluó a través de la escala PEDro. Resultados De un total de 469 estudios localizados se seleccionaron 10 ensayos clínicos que cumplieron los criterios de inclusión. Se analizaron los sistemas de ludificación utilizados como parte del tratamiento rehabilitador en distintas afecciones neuromotoras en niños y adolescentes. La parálisis cerebral fue la afección con mayor número de estudios (n = 6), seguida del trastorno del desarrollo de la coordinación (n = 3). También se estudió la alteración del equilibrio y coordinación por causa neurológica (n = 1). Conclusión El uso de la ludificación en rehabilitación aporta beneficios al tratamiento convencional de las alteraciones neuromotoras en niños y adolescentes, siendo el incremento de la motivación y de la adherencia terapéutica los que mayor consenso han alcanzado entre autores. Fuerza, equilibrio, funcionalidad y coordinación son otras variables analizadas que, si bien sugieren mejoras, necesitarían futuras investigaciones para determinar una óptima dosificación. (AU)

Introduction Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. Methods We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. Results From a total of 469 studies, 10 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), and neurological impairment of balance and coordination (1). Conclusion The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage. (AU)