[Implementation of a virtual telehealth course for Chilean older adults and health students]. / Implementación de una jornada virtual de telesalud y capacitación masiva para personas mayores chilenas y estudiantes de la salud. Impacto en la cobertura.

BACKGROUND: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. AIM: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. MATERIAL AND METHODS: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. RESULTS: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. CONCLUSIONS: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.

Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization.

INTRODUCTION: Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS) is the first non-pharmacological multicenter randomized clinical trial (RCT) to prevent cognitive impairment in Latin America (LA). Our aim is to present the study design and discuss the strategies used for multicultural harmonization. METHODS: This 1-year RCT (working on a 1-year extension) investigates the feasibility of a multi-domain lifestyle intervention in LA and the efficacy of the intervention, primarily on cognitive function. An external harmonization process was carried out to follow the FINGER model, and an internal harmonization was performed to ensure this study was feasible and comparable across the 12 participating LA countries. RESULTS: Currently, 1549 participants have been screened, and 815 randomized. Participants are ethnically diverse (56% are Nestizo) and have high cardiovascular risk (39% have metabolic syndrome). DISCUSSION: LatAm-FINGERS overcame a significant challenge to combine the region's diversity into a multi-domain risk reduction intervention feasible across LA while preserving the original FINGER design.

Implementación de una jornada virtual de telesalud y capacitación masiva para personas mayores chilenas y estudiantes de la salud. Impacto en la cobertura / Implementation of a virtual telehealth course for Chilean older adults and health students

Background: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. Aim: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. Material and Methods: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. Results: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. Conclusions: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.

Dual-Task Gait as a Predictive Tool for Cognitive Impairment in Older Adults: A Systematic Review.

The use of the dual-task model as a cognitive-motor interface has been extensively investigated in cross-sectional studies as a training task in cognitive impairment. However, few existing longitudinal studies prove the usefulness of this tool as a clinical marker of cognitive impairment in older people. What is the evidence in prospective studies about dual-task gait as a predictor of cognitive impairment in older adults? This study aims to review and discuss the current state of knowledge in prospective studies on the use of dual-task gait as a predictive tool for cognitive impairment in older adults. The methodology used was a systematic review, according to the PRISMA criteria for the search, summarize and report. A search in 3 databases (Pubmed, Web of Science, and Scopus) was carried out until April 2021. The search terms used were: "(gait OR walking) AND (cognitive decline) AND (dual-task) AND (follow-up OR longitudinal OR long-term OR prospective OR cohort OR predict)." We included prospective research articles with older people with cognitive evaluation at the beginning and the end of the follow-up and dual-task gait paradigm as initial evaluation associated with the presentation of cognitive impairment prediction using any dual-task gait parameters. After exclusion criteria, 12 studies were reviewed. The results indicate that eight studies consider dual-task gait parameters a useful cognitive-motor tool, finding that some of the evaluated parameters of dual-task gait significantly correlate with cognitive impairment over time. The most promising DT parameters associated with cognitive impairment prediction seem to be gait speed, speed cost, DT time, numbers of words during DT, among others. In sum, this study reviews the variety of dual-task gait parameters and their relevance as a simple tool for early cognitive impairment screening, opening a diagnostic window for the screening of cognitive impairment in older people.

"Surviving the Violence, Humiliation, and Loneliness Means Getting High": Violence, Loneliness, and Health of Female Sex Workers.

Sex workers are particularly vulnerable to violence, isolation, and stigmatization. This study uses the theory of loneliness to explore the relations among violence, self-esteem, loneliness, health, and drug use. Specifically, this study tested a model in which loneliness mediates the relationship between situational (violence) and characterological (self-esteem) loneliness factors and physical and psychological health and drug abuse. The study sample consisted of 146 sex workers from one region of Spain, recruited through the purposive sampling method. Partial least squares (PLS) path modeling has been employed to test the hypothesis. The findings of this study suggest that two kinds of violence (physical and psychological) have a direct and positive influence on loneliness, so that higher levels of violence increase loneliness, while self-esteem has a protector role on loneliness. Loneliness has a direct and negative impact on psychological and physical health, and determines an increase in drug use, which, in turn, decreases both physical and psychological health. The results support, among other points, that policy makers and sex worker service programs need to be aware of how loneliness plays a role in the health and risk behavior of sex workers. Society has an important role to improve sex workers' health and minimize their risk behavior.

Continuous acidogenic fermentation: Narrowing the gap between laboratory testing and industrial application.

This study explored the potential of acidogenic fermentation of sewage sludge (SS) in an 80 L automatized pilot scale platform. A high-rate VFA production was obtained at HRT 5 d and pH 9, with a volatile fatty acid (VFA) yield of 336 mg VFA g-1 VS and a VFA productivity of 2.15 kg VFA m-3 d-1. During co-fermentation of SS with OFMSW, a reversible pH shift from pH 9 to pH 6, evidenced a higher acidogenic activity which promoted the butyrate metabolic pathway, with 13.97 g COD L-1 of butyric acid and a VFA peak 23.2 g COD L-1. The results show the degree of flexibility of mixed culture fermentation systems, where other pH control methods other than steady control could be used to enhance the fermentation process. Ultrafiltration was a feasible technology to obtain a VFA rich permeate where 12.3-26.6 g COD L-1 could be recovered.

Model-based design of a software sensor for real-time diagnosis of the stability conditions in high-rate anaerobic reactors - Full-scale application to Internal Circulation technology.

Internal Circulation (IC) anaerobic systems are especially suitable when plant designs that involve both small footprints and high organic loading rates (>25 kg COD m-3 d-1) are required. However, given that operating anaerobic processes at high organic loads increases their vulnerability to external disturbances, real-time indicators of the stability conditions become particularly pertinent for IC reactors. This paper addresses the design and full-scale validation of a software sensor that uses only feeding flow-rate and biogas flow-rate measurements to classify the operating conditions of the reactor as "strongly", "moderately" or "weakly" stable. A simulation-based procedure was used to design the software sensor and configure its parameters. Then, the performance of the software sensor was tested under real conditions in a full-scale IC reactor of 1679 m3 installed in a recycled paper mill (RPM).

Exploring causes and consequences of sex workers' psychological health: Implications for health care policy. A study conducted in Spain.

The aim of the researchers is to explore the causes and consequences of the psychological health of sex workers as well as provide an intervention model for the prevention of mental disorders in accordance with World Health Organization (WHO) levels. The study sample consisted of 146 sex workers from Spain. Loneliness and maltreatment have a negative influence on psychological health, while self-esteem has a protector role over psychological health. Psychological health has a positive impact on perceived quality of life and other health domains. On the contrary, psychological health has a negative impact on drug use and symptoms of anxiety. Data are discussed.

Selective VFA production potential from organic waste streams: Assessing temperature and pH influence.

This study explored the volatile fatty acid (VFA) production potential of seven waste streams from urban and agroindustrial sources. For that purpose, batch assays were performed under acidic (pH 5.5) and alkaline (pH 10) conditions at both mesophilic (35°C) and thermophilic (55°C) temperature. Overall, the VFA yield was influenced by temperature, and it was positively affected by pH, ranging between 220 and 677mgCODg-1CODfed for liquid waste streams and between 127 and 611mgCODg-1CODfed for solid waste streams and urban sludge. The highest VFA concentration and highest VFA/sCOD ratio was obtained during the organic fraction of municipal solid waste (OFMSW) fermentation, with 8,320mgCODL-1 and 94% at alkaline pH and mesophilic temperature. The results of this study suggest that selective VFA production, i.e. via propionic, butyric and acetic acid production, might be feasible for scaling-up purposes with specific waste streams by adjusting the process parameters.

No effect of mercury exposure on kidney function during ongoing artisanal gold mining activities in Colombia.

This cross-sectional study examined whether people who are exposed to mercury (Hg) vapours in ongoing artisanal gold mining activities have alteration in kidney function monitoring parameters. The study enrolled 164 miners and 127 participant controls. The Hg concentrations for miners and control participants were measured in blood (B-Hg; median 7.0 vs. 2.5 µg/L), urine (U-Hg; median 3.9 vs. 1.5 µg/g creatinine) and hair (H-Hg; median 0.8 vs. 0.4 µg/g hair). The biomarkers of renal function were creatinine, albumin and excretion of ß-2 microglobulin. Glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration equation. Significant statistical differences were found in Hg concentrations and eGFR levels between the two study groups ( p < 0.01) but not with the other biomarkers of renal function. A multiple regression model was applied to explore the relationship of eGFR levels and Hg concentrations. However, no association was found between the prevalence of reduced eGFR (<71.96 mL/min/1.73 m2) and the B-Hg or U-Hg levels after adjustment for covariates. Nevertheless, it was observed that having B-Hg levels above 10 µg Hg/L decreased the eGFR by 1.7 mL/min/1.73 m2 (confidence interval 95% -5.1 to 1.7) compared to having levels below 2.0 µg Hg/L. Our results found no support for kidney damage associated with Hg vapour exposure in ongoing artisanal gold mining, whose population has a level of Hg exposure from low to moderate (B-Hg from 3.4 to 11.0 µg/L and U-Hg from 1.3 to 9.6 µg/g creatinine).

Trastorno de Asperger y trastorno del espectro del autismo: de la clarificación diagnóstica a la intervención en contextos naturales / Asperger disorder and autism spectrum disorder: from clarification to intervention in natural contexts

Desde su aparición en los sistemas clasificatorios oficiales, el diagnóstico del trastorno de Asperger ha sido fuente de numerosas investigaciones para su identificación y diferenciación con otros trastornos del desarrollo (p. ej., trastorno autista). Posteriormente, las investigaciones se centraron en los programas de intervención más eficaces para su recuperación. En el momento actual la investigación y la práctica clínica se centran en los procedimientos de intervención que garanticen la transferencia de resultados, haciendo énfasis en sus capacidades (puntos fuertes), más que en sus debilidades (puntos débiles). En el presente artículo se consideran los efectos beneficiosos de las intervenciones en contextos naturales, desde un enfoque positivo, que partiendo de los síntomas y características clínicas, se centran en los puntos fuertes como medio para superar sus dificultades (AU)

Since its appearance in the official classificatory systems, the diagnosis of Asperger’s Disorder has been the basis of numerous research studies aiming at its identification and differentiation from other development disorders (e.g., autism disorder). In a second stage, research studies were focused on the most effective intervention programmes to improve recovery. At present, both research and clinical practice are focused on intervention procedures that guarantee the transfer of results with an emphasis on their capacities (strong points), more than on their weaknesses (weak points). This article addresses, using a positive approach, the beneficial effects of the interventions in natural contexts which, starting from the symptoms and clinical characteristics, are focused on the strong points as a means to overcome difficulties

Training referential communicative skills to individuals with autism spectrum disorder: a pilot study.

The present study reports the effects of referential communication training in individuals formally diagnosed with autism spectrum disorder (ASD). Participants were 20 children with ASD (M age = 14.3 yr., SD = 4.2; 6 girls, 14 boys) in the role of speakers and 20 control children, who acted as listeners. They were all enrolled in mainstream compulsory education. Inclusion/exclusion criteria were defined according to the clinical diagnosis of ASD, the presence or absence of additional or associated disability, previous training in referential communication, and any drug treatment. Speakers were randomly assigned to one of two groups (trained vs untrained). Linguistic age, cognitive level and autistic symptoms were analyzed, respectively, with the Peabody Picture Vocabulary Test (PPVT), the Wechsler Intelligence Scale (WISC-R or WAIS-III), and the Autistic Behavior Checklist (ABC). Communicative abilities were analyzed through two indexes related to message complexity and self-regulation. The trained group was trained in referential communication tasks (task analysis, role taking, and task evaluation), while the untrained group took part in a communicative game but without any specific communicative training. The results showed that the complexity of emitted messages had improved statistically significantly in the trained group as an effect of training. Ecological referential communication is shown to be an appropriate paradigm for studying the communicative process and its products and could be used to develop and implement a training program focused on those skills in which individuals with ASD are most deficient.

[Clinical manifestations of lead levels in children exposed to automobile battery recycling processes in Soacha and Bogotá, D.C]. / Aspectos clínicos y niveles de plomo en niños expuestos de manera paraocupacional en el proceso de reciclaje de baterías de automóviles en las localidades de Soacha y Bogotá, D.C.

INTRODUCTION: Lead is a harmless metal if not handled directly in the industrial process. Even thought lead has been eliminated from the gasoline in many countries, automobile battery recycling continues to be a potential source of exposure and intoxication for the workers and their families, particularly of low income. The current investigation was initiated after an index case of lead poisoning was reported from Soacha, Cundinamarca, in central Colombia. OBJECTIVE: Clinical investigation established lead levels and lead poison frequency in children with para-occupational lead exposure in the process of recycling automobile batteries. MATERIAL AND METHODS: This was designed as a descriptive study, with selection of subjects with high risk of possible lead exposure. Minors, mostly of school age were recruited based on referral by relatives, neighbors or acquaintances, all of whom were involved in para-occupational exposure. Thirty two children, less than 12 years old (majority school age), were included. General and specific examinations of the children were made, and blood samples were taken for lead and hematological determinations. RESULTS: All subjects showed high levels of lead (2-9 times the maximum acceptable value) and, according to established criteria, two-thirds were rated as severely poisoned. The children with high levels of lead had tendency toward more specific hematological compromise and showing black gingival bordering (Burton border). CONCLUSION: This study communicates to the sanitary authorities and government a clear sign of alarm in that measures must be taken to diminish the occupational or para-occupational lead exposure of children by way of the automobile battery recycling industry.

Aspectos clínicos y niveles de plomo en niños expuestos de manera para ocupacional en el proceso de reciclaje de bade automóviles en las localidades de Soacha y Bogotá, D.C. de automóviles en las localidades de Soacha y Bogotá D.C / Clinical manifestations of lead levels in children exposed to automobile battery recycling processes in Soacha and Bogotá, D. C

Introducción. El plomo es un metal inocuo mientras no sea objeto de manipulación en procesos industriales. Aun cuando se ha eliminado la gasolina con plomo en muchos países, incluso en Colombia, el reciclaje informal de baterías sigue siendo una fuente potencial de exposición e intoxicación, tanto para los trabajadores como para sus familias, en los estratos bajos. Objetivo. Establecer hallazgos clínicos, niveles de plomo en sangre y frecuencia de intoxicación en niños expuestos de manera paraocupacional al reciclaje informal de baterías de automoviles. Materiales y métodos. Estudio descriptivo con selección por la exposición. La investigación se inició tras conocerse un caso índice de intoxicación en la población de Soacha, Cundinamarca. Se incluyeron consecutivamente a menores de edad, referidos por familiares, vecinos o conocidos, quienes se conocieran en exposición paraocupacional. Los menores fueron examinados y se tomaron muestras de sangre para determinación hematológica y dosificación de plomo. Resultados. Se examinaron 32 menores de 12 años, la mayoría en etapa escolar; todos presentaban altos niveles de plomo (dos a nueve veces el valor máximo aceptable) y dos tercios de ellos se encontraban con intoxicación grave. La serie de expuestos es significativamente sintomática en relación con los hallazgos sugestivos de intoxicación por plomo. Los niños con mayores niveles de plomo tenían la tendencia a presentar un mayor compromiso hematológico y a hacer manifiesto el ribete de Burton. Conclusión. Este trabajo descriptivo aporta un claro signo de alarma ante las autoridades sanitarias y de gobierno, a fin de tomar medidas tendientes a disminuir la exposición ocupacional, o paraocupacional de los niños, al reciclaje de baterías, mediante un programa de prevención y tamización en municipios y localidades del área metropolitana de Bogotá y Soacha.