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Dietary patterns (DPs) are an essential tool to analyze the relationship between diet and health as they have presented an association with the incidence of chronic non-communicable diseases. Therefore, the aim of this study was the identification and characterization of DPs and their association with cardiovascular risk factors. For this purpose, a cross-sectional descriptive study was carried out in 165 Mexican adults, including dietary intakes derived from a validated food frequency questionnaire, clinical history, anthropometry, and biochemical biomarkers using standardized procedures for glucose, total cholesterol, triglycerides, LDL-c, and HDL-c. DPs were identified through principal component analysis and ordinal logistic regression was used to examine associations between DPs and cardiovascular disease risk factors. Three DPs were identified: Mexican Fast-Food, Variety-Food, and Healthy-Economic, with a high prevalence of overweight and obesity (78%). Having a high adherence to a Mexican Fast-Food pattern (OR 1.71 CI 1.4-2.8), being sedentary (OR 4.85 2.32-10.15) and smoking (0R 6.4 CI 2.40-16.9) increased the risk of having a high scale of risk factors (four or more risk factors simultaneously). In conclusion, the Mexican Fast-Food pattern showed an increase in the risk of having multiple risk factors, while a sedentary lifestyle and overeating were largely responsible for the prevalence of overweight and obesity in this group of Mexican adults.
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Enfermedades Cardiovasculares , Patrones Dietéticos , Adulto , Humanos , Estudios Transversales , Sobrepeso/epidemiología , Sobrepeso/complicaciones , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Conducta Alimentaria , Dieta/efectos adversos , Obesidad/epidemiología , Obesidad/complicaciones , Factores de Riesgo , Factores de Riesgo de Enfermedad CardiacaRESUMEN
BACKGROUND: Unemployment rates for people living with mental illness remain persistently high. Individual Placement Support (IPS) is an evidence-based employment model that supports people with severe mental illness to gain employment. Although carers provide emotional and instrumental support for people with mental illness, there is limited research exploring carers' perspectives of IPS. AIMS: To explore carers' perspectives of their experience as caregivers of individuals living with mental illness who have participated in IPS. METHODS: This qualitative descriptive study gained carers' perspectives through semi-structured interviews. A convenience sample of eight carers was recruited via a community mental health service in Adelaide. Data were analysed thematically. FINDINGS: Three main themes were identified: (1) employment benefits, (2) factors that may impact on employment, and (3) knowledge and opinions of IPS. Within each theme, four sub-themes emerged. CONCLUSIONS: This study addresses a gap in research and provides insights into carers' experiences of IPS. Increased communication and involvement of carers in IPS may benefit IPS participants and staff as carers provide invaluable additional insight into supporting individuals through their employment journey.
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Trastornos Mentales , Terapia Ocupacional , Humanos , Cuidadores/psicología , Trastornos Mentales/psicología , Investigación Cualitativa , EmpleoRESUMEN
The spike (S) protein of SARS-CoV-2 is a molecular target of great interest for developing drug therapies against COVID-19 because S is responsible for the interaction of the virus with the host cell receptor. Currently, there is no outpatient safety treatment for COVID-19 disease. Furthermore, we consider it of worthy importance to evaluate experimentally the possible interaction of drugs (approved by the Food and Drug Administration) and the S, considering some previously in silico and clinical use. Then, the objective of this study was to demonstrate the in vitro interaction of ivermectin with S. The equilibrium dialysis technique with UV-Vis was performed to obtain the affinity and dissociation constants. In addition, the Drug Affinity Responsive Target Stability (DARTS) technique was used to demonstrate the in vitro interaction of S with ivermectin. The results indicate the interaction between ivermectin and the S with an association and dissociation constant of Ka = 1.22 µM-1 and Kd = 0.81 µM, respectively. The interaction was demonstrated in ratios of 1:50 pmol and 1:100 pmol (S: ivermectin) by the DARTS technique. The results obtained with these two different techniques demonstrate an interaction between S and ivermectin previously explored in silico, suggesting its clinical uses to stop the viral spread among susceptible human hosts.
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COVID-19 , Estados Unidos , Humanos , SARS-CoV-2/metabolismo , Glicoproteína de la Espiga del Coronavirus/metabolismo , Ivermectina/farmacología , Ivermectina/uso terapéuticoRESUMEN
Virgin olive oil (VOO) is a high-value product from the Mediterranean diet. Some health and nutritional benefits have been associated with its consumption, not only because of its monounsaturated-rich triacylglycerols but also due to its minor bioactive components. The search for specific metabolites related to VOO consumption may provide valuable information to identify the specific bioactive components and to understand possible molecular and metabolic mechanisms implicated in those health effects. In this regard, metabolomics, considered a key analytical tool in nutritional studies, offers a better understanding of the regulatory functions of food components on human nutrition, well-being, and health. For that reason, the aim of the present review is to summarize the available scientific evidence related to the metabolic effects of VOO or its minor bioactive compounds in human, animal, and in vitro studies using metabolomics approaches.
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Diet is a determinant for bodyweight and gut microbiota composition. Changes in dietary patterns are useful for the prevention and management of overweight and obesity. We aim to evaluate diet behavior and its potential association with selected gut bacteria and body weight among Mexican young adults. Mexican college students aged between 18 and 25 (normal-weight, overweight, and obese) were recruited. Anthropometric variables were recorded. A validated food frequency questionnaire was applied to all the participants. The percentages of macronutrients, fiber, and energy were calculated, and fecal samples were analyzed by real-time-qPCR to quantify selected gut bacteria. All the participants showed an unbalanced dietary pattern. However, the consumption of fruits, non-fat cereals, and oils and fats without protein were higher in the normal-weight individuals. In the overweight/obese participants, fiber intake did not correlate with the microbial variables, while Kcal from protein and Clostridium leptum correlated positively with Lactobacillus. Similarly, Clostridium coccoides-Eubacterium rectale correlated with Akkermansia muciniphila. In the normal-weight participants, Clostridium leptum and Lactobacillus correlated positively with Clostridium coccoides-Eubacterium rectale and Bifidobacterium, respectively, and Bacteroidetes negatively with Akkermansia muciniphila. In conclusion, a higher fiber intake had a positive impact on body weight and bacterial gut composition in this Mexican population of college students.
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Microbioma Gastrointestinal , Adolescente , Adulto , Dieta , Fibras de la Dieta , Heces/microbiología , Humanos , Obesidad/microbiología , Adulto JovenRESUMEN
El objetivo del presente estudio fue medir la curvatura vestíbulo-lingual de los conductos de las raíces mesiales de primeros molares inferiores en personas adultas del estado de Chihuahua, por medio de la técnica de tomografía computarizada de haz cónico (CBCT, por sus siglas en inglés) y usando el software de análisis 3D EndoTM (Dentsply/Sirona USA). Se llevó a cabo la medición por dos observadoras, empleando dos métodos diferentes, Schneider y 3D EndoTM (Dentsply/Sirona USA). Los resultados obtenidos tuvieron valores mayores a los 100 grados con la técnica 3D EndoTM y a los 20 grados con la técnica de Schneider. No se detectó una diferencia estadística significativa al comparar los diferentes conductos entre sí (AU)
The objective of the present study was to measure the vestibule-lingual curvature of the ducts of the mesial roots of lower first molars, of adults from the state of Chihuahua. Using the cone beam computed tomography (CBCT) technique and using the 3D analysis software EndoTM (Dentsply/Sirona USA). The measurement was carried out by two observers using two different methods, Schneider and 3D EndoTM (Dentsply/Sirona USA). The results obtained had values greater than 100 degrees with the 3D EndoTM technique and at 20 degrees with the Schneider technique. No statistically significant difference was detected when comparing the different ducts with each other (AU)
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Humanos , Cavidad Pulpar , Tomografía Computarizada de Haz Cónico , Diente Molar , Programas Informáticos , Imagenología Tridimensional , MéxicoRESUMEN
BACKGROUND: The role of hyaluronan (HA) in the development and progression of diabetic kidney disease (DKD), as well as the precise mechanisms and consequences of HA involvement in this pathology are still to be clarified. METHODS: In this study, we assayed the effects of the HA synthesis inhibitor 4-methylumbelliferone (4-MU) on the development of DKD. Diabetic type 2 model mice (eNOS-/- C57BLKS/Jdb) were fed artificial diets containing 5% 4-MU or not for 9 weeks. Plasma glucose, glomerular filtration rate (GFR), albumin to creatinine ratio (ACR), and biomarkers of kidney function and systemic inflammation were measured at baseline and after treatment. Diabetic nephropathy was further characterized in treated and control mice by histopathology. RESULTS: Treated animals consumed a daily dose of approximately 6.2 g of 4-MU per kg of body weight. At the end of the experimental period, the 4-MU supplemented diet resulted in a significant decrease in non-fasting plasma glucose (516 [interquartile range 378-1170] vs. 1149 [875.8-1287] mg/dL, P=0.050) and a trend toward lower HA kidney content (5.6 ± 1.5 vs. 8.8 ± 3.1 ng/mg of kidney weight, P=0.070) compared to the control diet, respectively. Diabetic animals treated with 4-MU showed significantly higher GFR and lower urine ACR and plasma cystatin C levels than diabetic controls. Independent histological assessment of DKD also demonstrated a significant decrease in mesangial expansion score and glomerular injury index in 4-MU-treated mice compared to controls. Plasma glucose showed a strong correlation with kidney HA levels (r=0.66, P=0.0098). Both total hyaluronan (r=0.76, P=0.0071) and low-molecular-weight hyaluronan content (r=0.64, P=0.036) in the kidneys correlated with urine ACR in mice. CONCLUSION: These results show that the hyaluronan synthesis inhibitor 4-MU effectively slowed the progression of DKD and constitutes a potential new therapeutic approach to treat DKD.
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Diabetes Mellitus , Nefropatías Diabéticas , Animales , Nefropatías Diabéticas/tratamiento farmacológico , Modelos Animales de Enfermedad , Tasa de Filtración Glomerular , Ácido Hialurónico/uso terapéutico , Riñón/patología , RatonesRESUMEN
INTRODUCTION: Unplanned extubation (UE) is orders of magnitude worse in low-income Pediatric Intensive Care Units (PICUs) than their high-income counterparts. Furthermore, a significant percent (20 %) of UEs result in a destabilizing event or cardiac collapse that negatively contributes to morbidity and mortality. As the principles of safe airway management are universal, we hypothesize that a multi-disciplinary educational intervention bundle which included provision of low-cost cuffed endotracheal tubes (ETT) and ETT tape will decrease the rate of unplanned extubation (UE) in a low-resourced PICU. METHODS: This is a pre-post interventional study powered to evaluate UE of intubated pediatric patients in an El Salvadorian PICU after a multi-disciplinary educational effort and provision of low-cost disposable materials. A multidisciplinary (otolaryngologists, intensivists, anesthesiologists, respiratory therapists, and nurses) educational curriculum involving hands on training, online video modules readily available via bedside QR codes, and pre- and post-testing was administered. The cost of the intervention materials was $1.32 per child. PICU mortality was evaluated as an exploratory outcome. RESULTS: Nine-hundred and fifty-seven (859 pre-intervention and 98 post-intervention) patients met inclusion criteria. Patients with one or more UEs decreased significantly from 29.4 % to 17.3 % post-intervention (p = 0.01; CI: 0.28-0.88) with an odds ratio of 0.51. The use of a cuffed ETT increased from 12 % to 36 % (p < 0.001; CI: 0.17-0.44; OR:3.74) and cuffed ETT use was associated with a reduction in UE with an odds ratio of 0.40 (p < 0.001; CI: 0.24-0.66). Finally, there was a 4.3 % decrease in pediatric mortality from 26.7 % to 22.4 % that equates to a number needed to treat to prevent a single child mortality of 23. Therefore, the ICER per mortality prevented is $30.7 and the ICER per Disability Adjusted Life Year (DALY) is $0.44. CONCLUSION: This multi-faceted intervention bundle is an accessible, scalable, cost-effective means to reduce UE and has implications in reducing global pediatric mortality.
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Extubación Traqueal , Intubación Intratraqueal , Manejo de la Vía Aérea , Niño , Curriculum , Humanos , Unidades de Cuidados Intensivos , Unidades de Cuidado Intensivo PediátricoRESUMEN
BACKGROUND: During the COVID-19 pandemic, healthcare professionals use personal protective equipment (PPE) on a constant basis and for extended periods, leading to adverse dermatological reactions, a situation little known and studied despite its relevance. OBJECTIVE: To determine the risk factors associated with the development of adverse dermatological reactions in health workers using PPE during the COVID-19 pandemic. MATERIAL AND METHODS: An observational, cross-sectional, analytical study conducted through an online survey that evaluated the association between dermatological reactions and the use of PPE through a descriptive and inferential statistical analysis. RESULTS: There was a sample of 171 healthcare professionals. It was reported a high prevalence of adverse reactions (59%) and the most affected sites were the facial region and hands. The use of PPE > 6 hours, a history of dermatological disease, female gender, use of plastic overalls and the use of a respirator were documented as risk factors. CONCLUSIONS: Being an infectious disease, COVID-19 forces healthcare professionals to use accessories as a form of personal protection, implying potential health risks; for this, effective preventive strategies and treatment are required.
INTRODUCCIÓN: durante la pandemia por COVID-19, los trabajadores de la salud utilizan equipos de protección personal (EPP) de forma constante y por periodos prolongados, lo cual propicia reacciones adversas dermatológicas, situación poco conocida y estudiada a pesar de su relevancia. OBJETIVO: determinar los factores de riesgo asociados al desarrollo de reacciones adversas dermatológicas en trabajadores de la salud que utilizan EPP durante la pandemia por COVID-19. MATERIAL Y MÉTODOS: estudio observacional, transversal, analítico, realizado mediante una encuesta en línea, que evaluó la asociación entre reacciones dermatológicas y el uso de EPP a partir de un análisis estadístico descriptivo e inferencial. RESULTADOS: se recabó una muestra de 171 trabajadores de la salud. Se reportó una alta prevalencia de reacciones adversas (59%) y los sitios más afectados fueron la región facial y las manos. El uso de EPP > 6 horas, el antecedente de enfermedad dermatológica, el género femenino, el uso de overol de plástico y el uso de respirador se documentaron como factores de riesgo. CONCLUSIONES: al ser una enfermedad infectocontagiosa, la COVID-19 condiciona que los trabajadores de salud utilicen aditamentos para su protección personal, lo cual implica potenciales riesgos para la salud; por tanto, se requieren estrategias preventivas y tratamientos eficaces.
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COVID-19 , Equipo de Protección Personal , Estudios Transversales , Femenino , Personal de Salud , Humanos , Pandemias , SARS-CoV-2RESUMEN
Resumen: Objetivo: Describir prácticas de consumo de bebidas y uso de bebederos escolares en estudiantes de secundarias del Programa Nacional de Bebederos Escolares (PNBE). Material y métodos: Estudio transversal descriptivo, con enfoque mixto en secundarias públicas (turnos matutino y vespertino). Se indagó el consumo de agua y bebidas azucaradas, utilización de bebederos escolares y barreras-facilitadores para el consumo de agua. Resultados. Se entrevistaron 617 estudiantes (11 a 16 años); 51.5% fueron hombres. El consumo promedio de agua (568.9 ml; IC95%: 470.7-667.1) y bebidas azucaradas (143.4 ml; IC95%:124.0-162.7) fue similar entre hombres y mujeres. En el turno matutino las mujeres presentaron una menor probabilidad de hacer uso de los bebederos en comparación con los hombres (p=0.032). Hombres y mujeres desconfían del agua de los bebederos. Conclusiones: Se requieren acciones integrales para favorecer el consumo de agua y el uso de los bebederos en las secundarias del PNBE.
Abstract: Objective: To describe beverages consumption practices, and school drinking fountains utilization among secondary school's students from National School Drinking Fountains Program (PNBE, Spanish acronym). Materials and methods: Descriptive cross-sectional study with mixed methods in public secondary schools (morning and afternoon shifts). We estimated plain water and sugar sweetened beverages consumption, school drinking fountains utilization, and barriers-facilitators for plain water consumption. Results: We interviewed 617 students (11 to 16 y); 51.5% were men. The mean of plain water intake (568.9 ml; CI95%: 470.7-667.1), and sugar sweetened beverages (143.4 ml; CI95%:124.0-162.7) was similar among women and men. In the morning shift women had a lower probability of utilizing the school drinking fountains in comparison with men (p=0.032). Men and women have mistrust water that comes from school drinking fountains. Conclusions: Integral actions are necessary to favor plain water consumption, and utilization of school drinking fountains at PNBE secondary schools.
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RESEARCH QUESTION: How is ovarian reserve affected by chemotherapy in patients with Hodgkin lymphoma (HL) who undergo fertility preservation (FP)? METHODS: A retrospective study was conducted by reviewing medical records of 105 HL patients referred to the FP unit before starting adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. Ovarian reserve was evaluated before chemotherapy and at the last follow-up using anti-Müllerian hormone (AMH) and antral follicle count (AFC) measurements. The decrease in AMH was compared with that expected from normograms. AMH was compared between patients who underwent cryopreservation of ovarian tissue and those who underwent cryopreservation of mature oocytes. RESULTS: After ABVD, 15% of patients required hematopoietic stem cell transplantation. At a median follow-up of 33 months, the median decrease in AMH was 0.88 ng/mL, which was significantly greater than that of the general population of this age group (p < 0.001). Of the 82 women who only had ABVD, 38 underwent FP by cryopreservation of mature oocytes and 44 underwent cryopreservation of the ovarian cortex. There was no significant difference in AMH or AFC at the last follow-up between FP techniques. CONCLUSION: Although ABVD is considered to be of low gonadotoxic risk, the decrease in AMH was greater than expected for patients' age, and 15% of patients needed more aggressive therapy during follow-up. Type of FP was not associated with decline in ovarian reserve. Reproductive-aged women with HL should have the opportunity for FP counseling before starting treatment.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Preservación de la Fertilidad , Enfermedad de Hodgkin/tratamiento farmacológico , Reserva Ovárica/efectos de los fármacos , Reserva Ovárica/fisiología , Adulto , Factores de Edad , Hormona Antimülleriana/sangre , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Bleomicina/efectos adversos , Bleomicina/uso terapéutico , Dacarbazina/efectos adversos , Dacarbazina/uso terapéutico , Doxorrubicina/efectos adversos , Doxorrubicina/uso terapéutico , Femenino , Trasplante de Células Madre Hematopoyéticas , Enfermedad de Hodgkin/fisiopatología , Enfermedad de Hodgkin/terapia , Humanos , Preservación de Órganos , Folículo Ovárico/efectos de los fármacos , Estudios Retrospectivos , Vinblastina/efectos adversos , Vinblastina/uso terapéuticoRESUMEN
BACKGROUND: Mexicans' adherence to food group's dietary recommendations is low and an inaccurate self-perception of dietary quality might perpetuate this low adherence. Our aim was to compare the intake and the adherence to the dietary recommendations for several food groups, subgroups, and to an overall Mexican Diet Quality Index (MxDQI), among those that perceived their diet as healthy vs. those that did not. METHODS: We analyzed data from 989 subjects 20-59 y old from the nationally representative Mexican National Health and Nutrition Survey 2016. Dietary intake was collected with one 24-h recall and a repeated recall in 82 subjects. Self-perception of dietary quality was evaluated with the following question "Do you consider that your diet is healthy? (yes/no)". We used the National Cancer Institute method to estimate the usual intake. We compared the mean intake adjusted by sociodemographic variables and the percentage of adherence according to the self-perception of dietary quality among the whole sample and in sociodemographic subpopulations. RESULTS: Sixty percent perceived their diet as healthy, and their adherence to recommendations was low [20% for fruits and vegetables, < 8% for legumes, seafood and SSBs, and ~ 50% for processed meats and high in saturated fat and/or added sugar (HSFAS) products]. The mean number of recommendations they met was 2.8 (out of 7) vs. 2.6 among the rest of the population (p > 0.05), and the MxDQI score was 40 vs. 37 (out of 100 points). The only food groups and subgroups with a statistically significant difference between those that perceived their diet as healthy vs. unhealthy were fruits [38 g/d (95% CI 3, 73)], fruit juices [27 g/d (95% CI 2, 52)], industrialized SSBs [- 35 kcal/d (- 70, - 1)] and salty snacks [- 40 kcal/d (- 79, - 1)]. Other differences were small or inconsistent across subgroups of the population. CONCLUSIONS: Those that perceived their diet as healthy only had a slightly healthier diet than the rest of the population, moreover, their adherence to recommendations was very low. Hence, it is necessary to improve their nutrition knowledge.
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Dieta , Ingestión de Energía , Adulto , Frutas , Humanos , Encuestas Nutricionales , Autoimagen , VerdurasRESUMEN
BACKGROUND: Incorporating consumers' voices in tertiary education curricula is an ongoing initiative of educators of health professions in order to facilitate students' readiness for consumer-based practice and to meet accreditation standards. Consequently, educators within these professions use a range of different strategies to involve, recruit and retain consumers. To date, no study has attempted to consolidate the different strategies used by nursing, midwifery and allied health educators to involve, recruit and retain consumers. Consolidating these strategies will lead to a sharing of ideas, which would be of benefit to educators looking for ways to involve consumers in their programs. OBJECTIVES: This scoping review aimed to identify how consumers are involved, recruited and retained in nursing, midwifery and allied health curricula, as reported within research from these professions. DESIGN: The scoping review was carried out and reported according to the PRISMA Extension for Scoping Reviews. DATA SOURCES: Eight electronic databases were searched on 8th January 2019 for English, peer-reviewed primary literature without limiting publication date. The databases were: Cochrane Library, Embase, Emcare, ERIC: Educational Resources Information Center database, Joanna Briggs Institute EBP database, Medline, Scopus, and Web of Science. REVIEW METHODS: The screening of studies was based on selection criteria and involved a two-stage process conducted by two independent reviewers. Once the studies were identified, two reviewers were involved in the charting process of each study. A form was developed to extract information regarding types of consumer involvement and strategies to recruit and retain consumers. Key concepts were then identified across the charted data and categorised and synthesised based on common characteristics or keywords. RESULTS: From 2334 studies, a total of 58 articles were included. Four main areas for consumer involvement types and eight strategies for recruitment and retention were identified and mapped across the studies. CONCLUSION: The collated findings allow idea sharing among educators from these professions on the various types of consumer involvement, recruitment and retention strategies. Enriching tertiary education programs with consumer input enhances student learning and assists these professions to meet accreditation standards.
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Partería , Competencia Clínica , Participación de la Comunidad , Femenino , Empleos en Salud , Humanos , Embarazo , UniversidadesRESUMEN
Objetivo. Describir prácticas de consumo de bebidas y uso de bebederos escolares en estudiantes de secundarias del Programa Nacional de Bebederos Escolares (PNBE). Material y métodos. Estudio transversal descriptivo, con enfoque mixto en secundarias públicas (turnos matutino y vespertino). Se indagó el consumo de agua y bebidas azucaradas, utilización de bebederos escolares y barreras-facilitadores para el consumo de agua. Resultados. Se entrevistaron 617 estudiantes (11 a 16 años); 51.5% fueron hombres. El consumo promedio de agua (568.9 ml; IC95%: 470.7-667.1) y bebidas azucaradas (143.4 ml; IC95%:124.0-162.7) fue similar entre hombres y mujeres. En el turno matutino las mujeres presentaron una menor probabilidad de hacer uso de los bebederos en comparación con los hombres (p=0.032). Hombres y mujeres desconfían del agua de los bebederos. Conclusiones. Se requieren acciones integrales para favorecer el consumo de agua y el uso de los bebederos en las secundarias del PNBE.
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Conducta de Ingestión de Líquido , Instituciones Académicas , Bebidas Azucaradas , Agua , Adolescente , Niño , Femenino , Humanos , Masculino , MéxicoRESUMEN
OBJECTIVE: Primary objective is to determine the rate of intubation with inappropriately sized endotracheal tubes (ETTs) in a pediatric intensive care unit (PICU) in El Salvador. Secondary objective is to determine effectiveness of a video-based curriculum to teach local providers on pediatric advanced airway management and surgical approach to patients requiring airway reconstruction. METHODS: Data for 296 intubated pediatric patients was collected over a six month period in a 16-bed PICU in El Salvador. Results of a learning behavior assessment survey completed by local healthcare workers informed a curriculum to complement on-site education during annual surgical airway mission trips. The video-based curriculum addressed proper sizing and use of cuffed endotracheal tubes, care of the intubated child and perioperative considerations of the surgical airway patient. Providers completed pre and post-curriculum quizzes to measure knowledge acquisition. RESULTS: Over 6-months, 281 patients were intubated. Sixty-three percent had improperly sized ETTs. Thirty-one percent had a failed or accidental extubation. All-cause mortality was 24%. One hundred and fifty-nine Salvadorian providers completed a learning behavior survey informing a video-based curriculum. Sixty-four providers completed the curriculum. Post-curriculum quiz scores increased by 18.7%. Surgeons, anesthesiologist, intensivists and speech pathologists demonstrated significant improvement (pâ¯<â¯0.05). CONCLUSION: Nearly two-thirds of intubated patients in a PICU in El Salvador have improperly sized ETTs and one-third require reintubation following planned or accidental extubation. The development of this first of its kind video-based curriculum for critical care and surgical training regarding how to properly care for the intubated child is coupled with the development of a longitudinal database to record pediatric airway related morbidity and mortality in the largest pediatric hospital in El Salvador. This model and system can be used to track the reduction in airway related morbidity and mortality directly related to a systems based intervention both in El Salvador and then elsewhere.
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Manejo de la Vía Aérea , Curriculum , Capacitación en Servicio , Intubación Intratraqueal , Niño , Competencia Clínica , Evaluación Educacional , El Salvador , Femenino , Hospitales Pediátricos , Humanos , Lactante , Unidades de Cuidado Intensivo Pediátrico , Masculino , Grabación en VideoRESUMEN
Whilst the geographical, sociological, and ecological roles of community gardens have been explored previously, the meanings associated with community gardening are unclear. This narrative inquiry study aimed to understand the meanings attributed to community gardening from an occupational science perspective. Photo elicitation was used alongside narrative interviewing with eight metropolitan South Australian community gardeners. Narrative analysis highlighted five themes: a sense of community; a chance to share; an opportunity to grow; a therapeutic place; ecological contributions. These themes aligned with four dimensions of meaning theorised in the occupational science literature - doing, being, belonging and becoming - with doing and belonging being most evident in our study. Health professionals are encouraged to consider community gardens as places that provide clients with opportunities for enhancing these dimensions of meaning, through engaging in a range of activities, experiencing a sense of belonging and strengthening their identity. By adopting an occupational science lens, these findings provide a new perspective on the importance of engaging in community gardening.
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Jardinería , Femenino , Jardines/organización & administración , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa , Características de la Residencia , Identificación Social , Australia del SurRESUMEN
For preschool children, mothers and teachers are the principal models and promoters of fruit, vegetable and simple water consumption at home and school, respectively. However, the daily intake of these food and drink items falls below recommended standards among Mexican adults, posing a high risk of non-communicable diseases such as overweight and obesity across all age groups in the country. The objective of this article is to describe the design, implementation and evaluation of an educational initiative conducted in a Mexican locality with the aim of promoting the consumption of fruits, vegetables (FVs) and simple water (SW) among preschoolers through the influence of their mothers and teachers. We used the Intervention Mapping methodology with qualitative and quantitative components. Mothers attended eight theoretical and practical sessions and two school meetings, while teachers were offered two workshops. Our results revealed positive changes among both groups: participants took greater interest in healthy nutrition, increased their purchase, preparation and intake of FVs and SW and promoted their consumption. This confirms that it is possible to achieve favorable changes in eating habits among those who participate in educational initiatives in Mexico.
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Salud Infantil , Dieta Saludable , Docentes , Promoción de la Salud/métodos , Madres , Adulto , Preescolar , Agua Potable , Femenino , Frutas , Conocimientos, Actitudes y Práctica en Salud , Humanos , México , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , VerdurasRESUMEN
Early childhood is a critical period for instilling healthy habits to prevent overweight and obesity. This paper describes the development of an educational intervention for the promotion of healthy eating and physical activity among two-to-four-year-old children in public child care centers (CCCs) in Mexico City. Following the Intervention Mapping (IM) protocol, we developed the Bright Futures multidisciplinary intervention. First, a formative research process to identify the personal and environmental determinants of childhood overweight and obesity, behavioral outcomes and performance objectives was conducted. Then, a matrix of change objectives by intersecting the performance objectives with the determinants was integrated. Bright Futures lasted six months and included 24 weekly sessions, each composed of five phases: warm-up, theory, active movements, relaxation, and hydration. Ad hoc interactive teaching materials focused on recreational activities, and formulated plans for the adoption, implementation and process/impact evaluation of the intervention was developed. IM successfully guided the design of a theory-driven and evidence-based intervention for children in CCCs within a socio-ecological and participatory planning framework. This is one of the first studies in Mexico to use IM in the context of CCCs.