Development and Implementation of a Culturally Informed Spanish Language Yoga Program for Latiné Women With Overweight or Obesity Diagnosed With Cancer: A Single Arm Pilot Study.

Background: Given limited yoga research in health disparities populations, we developed and evaluated a 12-week Spanish language yoga program for Latiné women with overweight or obesity affected by cancer. The program aimed to empower participants through culturally tailored yoga practice and opportunities for social connection and support. Methods: Partnering with a community-based organization, the program was co-created by bilingual (English and Spanish-speaking) yoga instructors, Latiné cancer survivor support professionals, and integrative medicine researchers. The single arm intervention consisted of 12 separate, 60-minute Hatha yoga classes, including physical postures, breathing exercises, culturally relevant poetry, and post-practice socialization opportunities. Measures were administered at baseline, 12-week, and 24-week. Results: Thirty-five eligible participants enrolled in the program, demonstrating high feasibility and relevance as well as high levels of engagement in home practice. Some participants faced barriers to regular home practice, including family responsibilities and concerns about proper pose execution. Preliminary outcome analyses indicated improvements in sleep disturbance, pain interference, depression, and blood pressure post-intervention, with sustained improvements in depression, anxiety, and blood pressure at 24-week. No significant changes were observed in fatigue, physical function, positive affect, satisfaction with social roles and activities, and weight. Structured post-practice social snack time with yoga instructors (compared with unstructured time with peers) was associated with self-reported improvements in satisfaction with social roles and activities and weight loss. Conclusion: This yoga program successfully engaged female Latiné cancer survivors with overweight and obesity and serves as a foundational step in empowering this population to improve their health and well-being through culturally tailored yoga practice. Future research should utilize controlled study designs and engage participants from different geographical regions to study the efficacy and sustainability of findings.

Association of vaccine status, reinfections, and risk factors with Long COVID syndrome.

The COVID-19 pandemic had a profound global impact, characterized by a high fatality rate and the emergence of enduring consequences known as Long COVID. Our study sought to determine the prevalence of Long COVID syndrome within a population of Northeastern Mexico, correlating it with patients' comorbidities, number of COVID-19 reinfection, and vaccination status. Employing an observational cross-sectional approach, we administered a comprehensive questionnaire covering medical history, demographics, vaccination status, COVID-related symptoms, and treatment. Our participant cohort included 807 patients, with an average age of 41.5 (SD 13.6) years, and women accounting 59.3% of the cohort. The follow-up was 488 (IQR 456) days. One hundred sixty-eight subjects (20.9%) met Long COVID criteria. Long COVID-19 was more prevalent when subjects had reinfections (p = 0.02) and less frequent when they had a complete vaccination scheme (p = 0.05). Through logistic regression, we found that male gender (OR 0.5, p ≤ 0.001), blood types of AB- (OR 0.48, p = 0.003) and O- (OR 0.27, p ≤ 0.001) in comparison with A+ and two doses of vaccines (OR 0.5, p = 006) to be protective factors against Long COVID; while higher BMI (OR 1.04, p = 0.005) was a risk factor. We saw that the prevalence of Long COVID was different within vaccinated patients and specific blood types, while being female and a higher BMI were associated with an increased risk of having long-COVID.

Scalp wound management: a narrative review from a neurosurgical perspective.

OBJECTIVE: This article aims to present a narrative review of current literature about the anatomical characteristics of the scalp as well as current practices in the management of surgical, traumatic and pressure injuries in the scalp, which are common in neurosurgery practice. METHOD: We searched PubMed for publications and book chapters in English from 2011 to 2021. We also included commonly referenced papers that we considered relevant to the subject with publication before these dates. We used the search terms 'laceration,' and/or 'neurosurgery' and/or, 'pressure injury,' and/or 'craniotomy,' and/or 'surgical incision' in combination with 'scalp,' and/or 'wound care.' We also searched the reference lists of publications identified by the search strategy and selected those that we judged relevant. RESULTS: We pre-selected 52 articles that covered various aspects of anatomy, pathophysiology, scalp wound management, or general wound care that we considered applied to the anatomical region of our interest. After abstract review, we selected 34 articles that met our search criteria and were included in our review. CONCLUSION: There is limited evidence regarding classification and care of scalp wounds. As a result, many of the current practices for scalp wound management are based on evidence derived from studies involving different anatomical regions, not considering its particular anatomy, vasculature and microbiome. Further research is needed for more comprehensive and effective protocols for the management of scalp injuries. However, this present review proposes responses to the identified gaps concerning the management of scalp wounds.

Response to sorafenib in a locally advanced oncocytic cell carcinoma of the thyroid.

We present the case of a female patient in her late 70s, diagnosed with widely invasive oncocytic cell carcinoma, with extrathyroidal extension, infiltration into the extrathyroidal muscle, involvement of the sternohyoid muscle and infiltration into the external muscle fibres of the oesophagus. Over the following year, metastases were documented in the lungs, bones and brain. Additionally, there was progression of the locally advanced lesion involving the airway and upper gastrointestinal tract. After considering iodine refractoriness, treatment with sorafenib was initiated. Notably, regression of the locoregional lesion at the cervical level was observed following treatment with the multikinase inhibitor.

Feasibility of Implementing a Mindfulness-Based Online Program for Latina Immigrants and the Staff that Work with Them.

Objective: Post-migration stress and trauma impact the way Latino/a immigrants in the USA experience everyday life. Mindfulness-based interventions (MBIs) reduce stress and strengthen mental health by improving the response to stressors and promoting physical and psychological well-being; however, they have not been tested extensively with Latino/a immigrants in the USA, particularly MBIs implemented online. Thus, more information is needed about the feasibility of online MBIs adapted for Latino/a immigrants. Method: This study focuses on the feasibility of an online MBI for Latina mothers and community staff members working with them (n = 41). Qualitative (three focus groups) data were collected to assess feasibility, appropriateness, acceptability, and quantitative (questionnaires) data asking about self-reported changes on stress, mindfulness, mind-body connection, subjective well-being, and perceived physical and mental health after the program. Results: Participants in the three groups indicated the program was appropriate, feasible, and acceptable for Latina immigrant mothers and the staff serving them. Mothers' and Promotoras' (community health workers) mean scores for subjective well-being and perceived physical and mental health increased significantly from baseline to post-test. No significant changes were observed in surveys completed by the staff, even though focus group participants reported meaningful improvement. Conclusion: Overall, the feasibility study was well received and relevant for the organization and the population they serve. The study's findings provide guidance to others who are implementing online mindfulness practices with Latina immigrants and the staff that work with them. Preregistration: This study is not preregistered. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02123-6.

Dimorfismo sexual del agujero magno en tomografías de una población peruana / Sexual dimorphism of the foramen magnum in CT scans of a Peruvian population

Introducción: La base del cráneo es una estructura compacta, muy resistente a los daños físicos, la robustez del hueso occipital y la posición anatómica protegida del agujero magno bajo una profundidad de tejido blando pueden hacerlo menos vulnerable a la fragmentación y a los efectos de los procesos tafonómicos en comparación con otras estructuras óseas, lo que permite utilizarlo para estimar el dimorfismo sexual. Objetivo: Establecer la relación entre el dimorfismo sexual y la morfometría del agujero magno en tomografías de pacientes mayores o iguales a los 18 años que asistieron a consultorios privados en Lima metropolitana, durante los años 2015 al 2020. Materiales y métodos: El estudio se desarrolló con 239 tomografías (88 masculinos y 151 femeninos). Se realizaron mediciones del agujero magno de los diámetros anteroposterior máximo (DAPM), transversal máximo (DTM) y el área se estableció mediante la fórmula de Teixeira (1982). Resultados: El DAPM presentó una media en el sexo masculino de 37,182 +/- 2,4012 mm y en el femenino de 34,795 +/- 2,1086 mm, mientras que para el DTM se estableció una media en el sexo masculino de 32,517 +/- 2,3463 mm y para el femenino de 30,514 +/- 2,2084 mm, en el área según Teixeira (1982) en el sexo masculino se observó una media de 957,21390 +/- 115,162403mm2 y en el femenino de 840,11055 +/- 93,775088mm2. Se establece una relación estadística (p<0.05) entre los parámetros DAPM, DTM, A Teixeira (1982) entre ambos sexos. Conclusión: Existe relación entre el dimorfismo sexual y la morfometría del agujero magno, con una predicción de 71.96%

Introduction: The base of the skull is a compact structure, very resistant to physical damage, the robustness of the occipital bone and the protected anatomical position of the foramen magnum under a depth of soft tissue may make it less vulnerable to fragmentation and to the effects of taphonomic processes compared to other bone structures, allowing it to be used to estimate sexual dimorphism. Objective: To establish the relationship between sexual dimorphism and the morphometry of the foramen magnum in CT scans of patients older or equal to 18 years of age who attended private clinics in metropolitan Lima, during the years 2015 to 2020. Materials and methods: The study was developed with 239 tomographies (88 male and 151 female). Foramen magnum measurements of the maximum anteroposterior diameters (DAPM), maximum transverse (DTM) were performed and the area was established using Teixeira's (1982) formula. Results: The DAPM presented a mean in the male sex of 37.182 +/- 2.4012 mm and in the female sex of 34.795 +/- 2.1086 mm, while for the DTM a mean was established in the male sex of 32.517 +/- 2, 3463 mm and for the female of 30.514 +/- 2.2084 mm, in the area according to Teixeira (A Teixeira) in the male sex a mean of 957.21390 +/- 115.162403mm2 and in the female sex of 840.11055 +/- 93.775088mm2 was observed. A statistical relationship (p<0.05) was established between the parameters DAPM, DTM, A TEIXEIRA between both sexes. Conclusion: There is a relationship between sexual dimorphism and foramen magnum morphometry, with a prediction of 71.96%

Building a More Diverse and Inclusive Science: Mindfulness-Based Approaches for Latinx Individuals.

Objectives: This article represents a call to action for the mindfulness field to be more diverse and inclusive of Latinx individuals. Building a diverse and inclusive science around mindfulness-based approaches (MBAs) that considers important group-level cultural and contextual information is an important public health challenge in need of innovative solutions. Methods: We describe ways that the Latinx population is poised to benefit from MBAs. We further elucidate challenges, describe potential solutions, and outline a research agenda that may hold promise for building a more inclusive mindfulness movement. Results: Our recommendations center around developing nuanced cultural adaptations to MBAs, engaging Latinx individuals in research, increasing the rigor of scientific studies pertaining to Latinx individuals, relying on implementation science to develop innovative methods for disseminating MBAs to Latinx individuals, developing training and certification mechanisms to increase diversity and representation of Latinx mindfulness teachers, and creating mechanisms for the oversight of MBAs within this group. Conclusions: There has been a lack of inclusivity of Latinx individuals in the field of MBAs with regards to research studies, barriers to access for economically disadvantaged groups, and lack of diversity in its workforce. Considering the recognition of adverse social drivers of health that generate chronic stress and health disparities, the Latinx population is especially poised to benefit greatly from MBAs. A diverse and inclusive mindfulness science holds promise to enhance the effectiveness, acceptability, feasibility, and wide-scale dissemination and implementation of MBAs.

Lessons Learned for Emergency Feeding During Modifications to 11 School Feeding Programs in Latin America and the Caribbean During the COVID-19 Pandemic.

BACKGROUND: School feeding programs (SFPs) can play a crucial role in the emergency food and nutrition response, but there is a dearth of information on how SFPs operate during emergencies. DESIGN AND METHODS: A rapid comparative assessment of 11 SFPs throughout Latin America and the Caribbean during the COVID-19 pandemic. Data from (1) systematic document search and (2) surveys with key informants (n = 23) about barriers/facilitators to modifications were systematically analyzed using a multiple case study approach. RESULTS: During the pandemic, all SFPs continued (although continuation plans varied from a few days in Chile to > 1 month in Puerto Rico) via food kits, food vouchers, and/or grab n' go meals. The SFP implementation was highly dependent on the programs' autonomy and financial support, which impacted their logistics to acquire and distribute foods during the pandemic. The types of foods offered in some SFPs suggest that established nutritional guidelines were not always followed. Key informants expressed concerns about the deterioration of the nutritional quality of foods offered during the pandemic and lack of community engagement that impeded distribution to the neediest. CONCLUSIONS: Results underscore the urgency for clear implementation guidance on how to modify SFP during emergencies. Public health implications include (1) allocation of autonomous resources to an intersectoral working group to safeguard nutritional benefits during emergencies, (2) strengthening efforts of SFP community engagement before and during emergencies, and (3) establishing guidelines of the types of foods that can be distributed to meet the nutritional needs of beneficiaries during emergencies.

Exosomes: Small vesicles with big roles in cancer, vaccine development, and therapeutics.

Cancer is a deadly disease that is globally and consistently one of the leading causes of mortality every year. Despite the availability of chemotherapy, radiotherapy, immunotherapy, and surgery, a cure for cancer has not been attained. Recently, exosomes have gained significant attention due to the therapeutic potential of their various components including proteins, lipids, nucleic acids, miRNAs, and lncRNAs. Exosomes constitute a set of tiny extracellular vesicles with an approximate diameter of 30-100 nm. They are released from different cells and are present in biofluids including blood, cerebrospinal fluid (CSF), and urine. They perform crucial multifaceted functions in the malignant progression of cancer via autocrine, paracrine, and endocrine communications. The ability of exosomes to carry different cargoes including drug and molecular information to recipient cells make them a novel tool for cancer therapeutics. In this review, we discuss the major components of exosomes and their role in cancer progression. We also review important literature about the potential role of exosomes as vaccines and delivery carriers in the context of cancer therapeutics.

El entorno construido en los programas diseñados para promover la actividad física entre las niñas, niños y jóvenes latinos que viven en Estados Unidos y América Latina.

Prevenir la obesidad entre los jóvenes latinos que viven en Estados Unidos y en países latinoamericanos requiere reconocer la especificidad de los contextos y las interacciones entre actividad física (AF) y entorno construido (EC). El objetivo de este artículo es avanzar en la agenda de investigación sobre el EC y la AF con el fin de prevenir la obesidad en Latinoamérica y entre los jóvenes latinos de Estados Unidos mediante (1) la identificación de indicadores del entorno que contribuyan en el diseño de intervenciones y políticas; (2) la identificación de enfoques metodológicos interdisciplinarios para el estudio de la relación compleja que se establece entre el EC y la AF y (3) la presentación de estudios de casos sobre programas de EC que promueven la AF. Un grupo de científicos estadounidenses y latinoamericanos trabajó en colaboración para proponer nuevos indicadores sobre el EC, establecer enfoques metodológicos que permitan estudiar la relación compleja entre EC y AF, y revisar estudios de caso sobre programas de EC que promueven la AF en ambas regiones. Como resultado, se identificaron lagunas de conocimiento, se propusieron indicadores del entorno (como el paisaje, el diseño de las calles, los patrones de movilidad, la delincuencia y la seguridad), se revisaron enfoques metodológicos (análisis de redes sociales, métodos de ciencia ciudadana) y se analizaron estudios de caso de programas del EC que promueven la AF (calles para el juego, desplazamiento activo a la escuela e intervenciones en el entorno escolar). La prevención de la obesidad entre los jóvenes latinos y latinoamericanos exige una investigación avanzada del EC y de la AF que aborde las prioridades específicas de cada contexto y permita intercambiar las lecciones aprendidas.

Capacidad de investigación en obesidad infantil en Latinoamérica y en las poblaciones latinas de Estados Unidos: estado de la investigación, problemas, oportunidades y líneas de trabajo para el futuro.

La obesidad infantil es un problema grave en Latinoamérica y entre la población latina de EE. UU. Para ser eficaces, las políticas de salud pública tienen que estar guiadas por evidencias contextuales pertinentes, lo cual exige una capacidad de investigación sostenida a través del tiempo. Los objetivos de este estudio son determinar la productividad de la investigación enfocada en las poblaciones latinas en Latinoamérica y Estados Unidos, y examinar los dominios de la capacidad de investigación (infraestructuras, programas de formación, mentoría, financiamiento y redes de contactos). Realizamos una revisión exploratoria de artículos indexados relacionados con la obesidad infantil publicados entre junio de 2015 y diciembre de 2019. Recabamos información sobre las percepciones de los investigadores latinoamericanos respecto a la capacidad de investigación en obesidad infantil a través de una encuesta en línea. Identificamos 612 artículos relacionados con la obesidad infantil (505 de Latinoamérica, 124 de EE. UU. y 17 de colaboraciones entre EE. UU. y Latinoamérica). Brasil, México, Chile, Colombia y Estados Unidos son los países con más publicaciones. Encontramos aproximadamente el mismo número de artículos sobre obesidad, nutrición y actividad física; sin embargo, observamos que la capacidad de investigación sobre actividad física está rezagada en otros dominios (formación en investigación, financiamiento y oportunidades para establecer contactos). Otras áreas de investigación complementarias, como el comportamiento sedentario, la ciencia de sistemas y los estudios de políticas, son poco frecuentes en Latinoamérica, pero más habituales en Estados Unidos, mientras que la investigación sobre el sueño es incipiente en ambas regiones. Para cumplir la promesa de crear un programa eficaz de colaboración transfronteriza para la prevención de la obesidad infantil será necesario invertir en todos los dominios de la capacidad de investigación y en todos los temas pertinentes.

Effectiveness of a Gamification Strategy to Prevent Childhood Obesity in Schools: A Cluster Controlled Trial.

OBJECTIVE: The aim of this study was to examine the effectiveness of a school-based gamification strategy to prevent childhood obesity. METHODS: Schools were randomized in Santiago, Chile, between March and May 2018 to control or to receive a nutrition and physical activity intervention using a gamification strategy (i.e., the use of points, levels, and rewards) to achieve healthy challenges. The intervention was delivered for 7 months and participants were assessed at 4 and 7 months. Primary outcomes were mean difference in BMI z score and waist circumference (WC) between trial arms at 7 months. Secondary outcomes were mean difference in BMI and systolic and diastolic blood pressure between trial arms at 7 months.  RESULTS: A total of 24 schools (5 controls) and 2,197 students (653 controls) were analyzed. Mean BMI z score was lower in the intervention arm compared with control (adjusted mean difference -0.133, 95% CI: -0.25 to -0.01), whereas no evidence of reduction in WC was found. Mean BMI and systolic blood pressure were lower in the intervention arm compared with control. No evidence of reduction in diastolic blood pressure was found. CONCLUSIONS: The multicomponent intervention was effective in preventing obesity but not in reducing WC. Gamification is a potentially powerful tool to increase the effectiveness of school-based interventions to prevent obesity.

Built environment in programs to promote physical activity among Latino children and youth living in the United States and in Latin America.

To prevent obesity among Latino youth in the United States and Latin America, it is necessary to understand the specific context and interplay of physical activity (PA) and the built environment (BE). This paper aims to advance the research agenda of BE and PA for obesity prevention in Latin America and among Latino youth in the United States by (1) identifying environmental indicators to inform the design of interventions and policy, (2) identifying interdisciplinary methodological approaches for the study of the complex association between BE and PA, and (3) presenting case studies of PA-promoting BE programs. A group of U.S. and Latin American scientists collaboratively worked to propose innovative indicators of the BE, methodological approaches for the study of the complex association between BE and PA, and review case studies of PA-promoting BE programs in both regions. The results identified gaps in knowledge, proposed environmental indicators (e.g., landscape, street design, mobility patterns, and crime and safety), reviewed methodological approaches (social network analysis, citizen science methods), and case studies illustrating PA-promoting BE programs (i.e., play streets, active school transport, and school setting interventions). The obesity prevention among Latino and Latin American youth requires advanced research on BE and PA addressing context-specific priorities and exchanging lessons learned.

Capacity for childhood obesity research in Latin American and US Latino populations: State of the field, challenges, opportunities, and future directions.

Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.

Asociación entre lactancia materna y probabilidad de obesidad en la infancia en tres países latinoamericanos / Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries

Objetivo: Determinar si la lactancia materna ≥ 6 meses se asocia con menor sobrepeso y obesidad en niños/as de 2 a 5 años de edad. Método: Análisis transversal de datos de encuestas nacionales de demografía y salud de Bolivia, Colombia y Perú. Se definieron sobrepeso y obesidad según los criterios de la Organización Mundial de la Salud. Se calculó la odds ratio (OR) utilizando regresión logística multinomial. Resultados: La prevalencia de obesidad en niños/as de 2 a 5 años fue del 10,4% (intervalo de confianza del 95% [IC95%]: 8,2-12,6) en Bolivia, del 4,9% (IC95%: 4,0-5,8) en Colombia y del 6,4% (IC95%: 5,2-8,0) en Perú. La lactancia materna ≥ 6 meses en la población estudiada fue del 89,9% (IC95%: 87,8-91,9) en Bolivia, del 73,9% (IC95%: 72,2-75,6) en Colombia y del 92,8% (IC95%: 91,2-94,4) en Perú. Se encontró evidencia de asociación entre lactancia materna ≥ 6 meses y menor posibilidad de obesidad en comparación con no lactancia o lactancia < 6 meses para Bolivia (OR = 0,30; IC95%: 0,16-0,57), y una asociación marginal para Colombia (OR = 0,71; IC95%: 0,47-1,06) y Perú (OR = 0,49; IC95%: 0,23-1,04). No hubo evidencia de asociación entre lactancia materna y sobrepeso. Conclusión: La lactancia materna ≥ 6 meses está asociada con una menor posibilidad de tener obesidad en niños/as de 2 a 5 años en Bolivia. Este patrón fue similar, pero marginal, para Colombia y Perú. (AU)

Objective: To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. Method: Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. Results: The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. Conclusion: Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru. (AU)

Disparities in Text Messaging Interventions to Improve Diabetes Management in the United States.

Substantial progress has been made in the development of evidence-based interventions to facilitate the management of type 2 diabetes. The increase in ownership of mobile phones has made short messaging services (SMS, or text messaging) a feasible way to enhance information delivery. The goals of this study were to 1) summarize characteristics of diabetes SMS interventions implemented in the United States and 2) identify the extent to which disadvantaged populations are represented in SMS-based diabetes management intervention studies. We conducted a literature search to identify published studies of type 2 diabetes self-management SMS interventions conducted with adults in the United States. Of the 792 articles retrieved, only 9 met inclusion criteria. We systematically extracted data on the theoretical basis, recruitment, incentives, inclusion/exclusion criteria, strategies toward ensuring a racially/ethnically or income-diverse sample, text message delivery, and study duration. Sixty-three percent of the participants across the nine studies were non-white. Only two studies reported participants' education level, and four captured non-English-speaking status. Interventions varied in offering one-way, two-way, or a combination of messaging strategies. Five studies did not describe cultural adaptations or report results separately for different cultural groups. None of the studies provided cell phones, and not having texting capability was an exclusion criterion for six studies. There is a dearth of published research on type 2 diabetes management interventions using text messaging among racially/ethnically or income-diverse populations. Future interventions should be better tailored to these target populations and include the collection of complete sociodemographic data and cell phone/smartphone availability, thereby ensuring cultural appropriateness.

[Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries]. / Asociación entre lactancia materna y probabilidad de obesidad en la infancia en tres países latinoamericanos.

OBJECTIVE: To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. METHOD: Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. RESULTS: The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. CONCLUSION: Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru.

Geographic Distribution of the Ciclovia and Recreovia Programs by Neighborhood SES in Bogotá: How Unequal is the Geographic Access Assessed Via Distance-based Measures?

Ciclovia, also known as Open Streets initiatives in other countries, are city streets that are closed to motorized traffic and opened during certain times to residents for engaging in physical activity (PA). These initiatives are viewed by policy makers and health and community advocates as being beneficial to social, environmental, and community health. This study explores the geographic distribution of Ciclovia and Recreovia and the differences in geographic access assessed via distance-based measures, based on the socioeconomic status (SES) of the area. Results from this study show that the median distance to the Ciclovia according to SES ranges from 2930 m for SES 1 (most disadvantaged) to 482 m for SES 6 (wealthiest). The median distance to the Recreovia sites ranges from 5173 m for SES 1 to 3869 m for SES 6. This study found revealing urban inequities in the distribution of Ciclovia, whereas there was less inequalities within the Recreovia sites. This study shows that urban interventions are needed to promote recreational activity and reduce health disparities in under resourced, low SES areas.

Loss of MeCP2 Function Across Several Neuronal Populations Impairs Breathing Response to Acute Hypoxia.

Rett Syndrome (RTT) is a neurodevelopmental disorder caused by loss of function of the transcriptional regulator Methyl-CpG-Binding Protein 2 (MeCP2). In addition to the characteristic loss of hand function and spoken language after the first year of life, people with RTT also have a variety of physiological and autonomic abnormalities including disrupted breathing rhythms characterized by bouts of hyperventilation and an increased frequency of apnea. These breathing abnormalities, that likely involve alterations in both the circuitry underlying respiratory pace making and those underlying breathing response to environmental stimuli, may underlie the sudden unexpected death seen in a significant fraction of people with RTT. In fact, mice lacking MeCP2 function exhibit abnormal breathing rate response to acute hypoxia and maintain a persistently elevated breathing rate rather than showing typical hypoxic ventilatory decline that can be observed among their wild-type littermates. Using genetic and pharmacological tools to better understand the course of this abnormal hypoxic breathing rate response and the neurons driving it, we learned that the abnormal hypoxic breathing response is acquired as the animals mature, and that MeCP2 function is required within excitatory, inhibitory, and modulatory populations for a normal hypoxic breathing rate response. Furthermore, mice lacking MeCP2 exhibit decreased hypoxia-induced neuronal activity within the nucleus tractus solitarius of the dorsal medulla. Overall, these data provide insight into the neurons driving the circuit dysfunction that leads to breathing abnormalities upon loss of MeCP2. The discovery that combined dysfunction across multiple neuronal populations contributes to breathing dysfunction may provide insight into sudden unexpected death in RTT.

Association between high blood pressure and fitness and fatness in adolescents / Presión arterial alta asociada con condición física y adiposidad en adolescentes

Abstract Introduction: Excess adiposity is considered the most important risk factor for high blood pressure (HBP) in children and adolescents. Objectives: To explore the association between HBP and overweight (OW) and abdominal obesity (AO), mediated by cardiorespiratory fitness (CRF). To analyze the combined effect of excess adiposity and CRF on HBP among a sample of school-aged children from Montería, Colombia. Materials and methods: Cross-sectional study conducted in a sample of 546 adolescents aged between 11 and 18 years from 14 randomly selected schools in Montería. Blood pressure, anthropometric, and fitness measures were evaluated by trained personnel using standardized protocols and instrumentation. The association of HBP with fitness and fatness was analyzed using logistic regression models. Results: HBP was associated with OW, AO and low CRF. The inclusion of CRF in this model did not attenuate the association between HBP and OW and between HPB and AO. Adolescents with higher adiposity and low CRF were more likely to have HBP compared with those with lower adiposity and high CRF. Moreover, it was found that excess adiposity and low CRF had an additive effect on the risk for HBP among the sample. Conclusion: HBP is a prevalent condition in children and adolescents from Montería, Colombia. HBP is significantly associated with OW, AO, and low CRF; therefore, it is necessary to implement initiatives to promote healthy habits aimed at this population in order to reduce the incidence rate of HBP in Colombian adolescents.

Resumen Introducción. El exceso de adiposidad es considerado como el factor de riesgo más importante para la presión arterial alta (PAA) en niños y adolescentes. Objetivos. Explorar la asociación entre PAA y sobrepeso (SP) y obesidad abdominal (OA), mediada por condición física cardiorrespiratoria (CFC), y analizar el efecto combinado de la adiposidad excesiva y la CFC en la PAA en una muestra de escolares de Montería, Colombia. Materiales y métodos. Estudio transversal realizado en 546 adolescentes con edades entre 11 y 18 años de 14 escuelas seleccionadas aleatoriamente en Montería. Se evaluó la presión arterial, los indicadores antropométricos y la condición física; las mediciones fueron realizadas por personal capacitado mediante el uso de protocolos e instrumentos estandarizados. La asociación de PAA con condición física y adiposidad fue analizada a través de modelos de regresión logística. Resultados. Se encontró una asociación entre PAA y SP, OA y baja CFC. La inclusion de la CFC en el modelo no atenuó la asociación entre PAA y SP y entre PAA y OA. Los adolescentes con mayor adiposidad y baja CFC fueron más propensos a presentar PAA que aquellos con menor adiposidad y alta CFC. Además, se observó que la presencia de adiposidad excesiva y baja CFC aumenta el riesgo de desarrollar PAA. Conclusión. La PAA es una condición prevalente en niños y adolescentes de Montería, además se encontró una asociación estádisticamente significativa entre PAA y SP, OA, y baja CFC, por lo que es necesario que en el país se implementen estrategias que promuevan hábitos saludables en escolares y permitan reducir la tasa de incidencia de PAA en esta población.