Prevalencia de sobrepeso y obesidad en Aragón y variaciones según condicionantes de salud / Prevalence of overweight and obesity in Aragón and variations according to health determinants

Introducción: La obesidad infantil constituye un grave problema de salud global en continuo aumento en todo el mundo. Muchos estudios señalan que determinados factores socioeconómicos están relacionados con el desarrollo de obesidad. El objetivo de este estudio fue analizar la prevalencia de sobrepeso y obesidad en Aragón, calculadas según los estándares de la Organización Mundial de la Salud (OMS) y estudiar su relación con factores socioeconómicos. Material y métodos: Se recopiló información sobre la totalidad de la población infantil de Aragón entre dos y 14 años y cada individuo fue clasificado como normopeso, sobrepeso u obesidad según su índice de masa corporal (IMC). Se obtuvieron las prevalencias por provincias y zonas básicas de salud (ZBS). Utilizamos el índice de privación (IP) de Aragón como marcador de la situación socioeconómica. Resultados: La muestra final estuvo constituida por 161.335 niños (51%) y niñas (49%) de dos a 14 años. La prevalencia global de sobrecarga ponderal (SP) fue de 31,1% (17,7% sobrepeso y 13,3% obesidad), siendo significativamente mayor en niños. Detectamos un porcentaje elevado (65%) de infrarregistro en la historia clínica.Se encontró una relación directa entre el IP y la prevalencia de obesidad y SP en todo Aragón, con una fuerte correlación significativa en zonas urbanas, en las que los factores socioeconómicos llegan a explicar hasta 66,4% de la obesidad y 48,9% de la SP total. Conclusiones: En Aragón, la prevalencia de obesidad y SP es elevada y está relacionada con una situación socioeconómica familiar desfavorable. (AU)

Introduction: Childhood obesity is a serious global health problem that is continuously increasing worldwide. Many studies suggest that socioeconomic factors are related to the development of obesity. The objective of our study was to analyse the prevalence of overweight and obesity in Aragón, calculated applying the World Health Organization (WHO) growth standards, and to study its association with socioeconomic factors. Material and methods: We collected data for the entire paediatric population of Aragón aged 2–14 years. We classified each child as normal weight, overweight or obese based on the body mass index. We calculated prevalences by province and basic health care zone. To analyse differences in relation to social inequalities, we used the Aragón deprivation index as an indicator of socioeconomic status. Results: The final sample consisted of 161 335 children aged 2–14 years, 51% male and 49% female. The overall prevalence of excess weight was 31.1% (17.7% overweight and 13.3% obesity) and was significantly higher in boys. We found a high frequency of under-recording in health records (65%). There was a direct association between the deprivation index and the prevalence of obesity and overweight throughout Aragón, with a significant strong correlation in urban areas, where socioeconomic factors explained up to 66.4% of obesity and 48.9% of body weight excess. Conclusions: In Aragón, the prevalence of obesity and excess weight is high and associated with low family socioeconomic status. (AU)

Prevalence of overweight and obesity in Aragón and variations according to health determinants.

INTRODUCTION: Childhood obesity is a serious global health problem that is continuously increasing worldwide. Many studies suggest that socioeconomic factors are related to the development of obesity. The objective of our study was to analyse the prevalence of overweight and obesity in Aragón, calculated applying the World Health Organization (WHO) growth standards, and to study its association with socioeconomic factors. MATERIAL AND METHODS: We collected data for the entire paediatric population of Aragón aged 2-14 years. We classified each child as normal weight, overweight or obese based on the body mass index. We calculated prevalences by province and basic health care zone. To analyse differences in relation to social inequalities, we used the Aragón deprivation index as an indicator of socioeconomic status. RESULTS: The final sample consisted of 161 335 children aged 2-14 years, 51% male and 49% female. The overall prevalence of excess weight was 31.1% (17.7% overweight and 13.3% obesity) and was significantly higher in boys. We found a high frequency of under-recording in health records (65%). There was a direct association between the deprivation index and the prevalence of obesity and overweight throughout Aragón, with a significant strong correlation in urban areas, where socioeconomic factors explained up to 66.4% of obesity and 48.9% of body weight excess. CONCLUSIONS: In Aragón, the prevalence of obesity and excess weight is high and associated with low family socioeconomic status.

Corporate donation behavior during the covid-19 pandemic. A case-study approach in the multinational inditex.

The situation created by the COVID-19 pandemic, especially the confinement in many countries, has led to a global crisis, not only in health but also in economy and social issues. But it has also provoked a wave of solidarity and unprecedented donation behavior by many companies worldwide. Inditex, one of the main fashion multinationals, has become a referent for its reaction speed and has been ranked number one among the most significant companies for its Corporate Social Responsibility during the lockdown. Drawing from Stakeholder, Legitimacy, and Ethics of Care Theories, the aim of this paper is to analyze Inditex as a case study and reflect on the impact of its donation behavior on its corporate reputation. A desk research approach by using secondary data about the corporation, and a content analysis of press releases with ATLASti software during this time, let conclude that effective corporate donation impacts and improves the reputation of the corporation among its stakeholders.

Overwhelmed by Technostress? Sensitive Archetypes and Effects in Times of Forced Digitalization.

This paper explores technostress and its dimensions, assessing the relationship with possible negative effects in the individual, social and professional sphere. The study uses a self-reported approach of undergraduate students in Spain (n = 337), forced to follow their academic life by using technology comprehensively because of social distancing, as a public health action necessary to reduce the spread of COVID-19. The analysis, based on the exploration of a system of archetypes of the use of social networks, presents insights into contemporary technostress management as a new approach that can suppose opportunities for the optimization of prevention plans. Pearson's correlation coefficients and structural equation modeling based on partial least squares (SEM-PLS) were the methods used for achieving the goals. The results reveal valid and reliable measures where technostress has a high impact on the individual sphere of students and there is a significant relationship between the type of user and techno-anxiety. The conclusions point to the imperative for developing a deeper understanding of technostress by archetypes, in both a higher education context (as antecedent) and the world of work, in an irreversible move towards a digital economy.

The Negative Effect of Job Insecurity in the Virtuous Cycle Between Trust in the Organization, Subjective Well-Being, and Task Performance in the Current Volatility, Uncertainty, Complexity, and Ambiguity Context.

Over the past decade, job insecurity referring to the employees' perceived threat to the continuity and stability of employment as it is currently experienced has become a hot topic. A general assumption, supported by the findings, is that job insecurity causes far-reaching negative consequences for the employee health and well-being, attitudes toward organization and the job, and behaviors at work. However, the focus on behavioral outcomes, especially on employee performance at work, is still scant. Moreover, the literature remains fragmented concerning the impact of job insecurity on employee trust in the organization and how the trust influences employee subjective well-being (SWB), which in turn affects employee performance. Consequently, the link between job insecurity and SWB needs more investigation. Trying to narrow the gap, the paper aims at revealing the linkage between job insecurity, trust in the organization, SWB, and task performance. Quantitative data were collected in Lithuania. As predicted, the results revealed that job insecurity had a negative impact on trust in the organization and employee SWB. In case of linkage between job insecurity and task performance, the hypothesis was rejected. In general, these findings affirmed that job insecurity was a hindrance stressor, which needed to be considered when managing human resources in the current volatility, uncertainty, complexity, and ambiguity context.

Predicting Stomatal Closure and Turgor Loss in Woody Plants Using Predawn and Midday Water Potential.

Knowledge about physiological stress thresholds provides crucial information about plant performance and survival under drought. In this study, we report on the triphasic nature of the relationship between plant water potential (Ψ) at predawn and midday and describe a method that predicts Ψ at stomatal closure and turgor loss exclusively from this water potential curve (WP curve). The method is based on a piecewise linear regression model that was developed to predict the boundaries (termed Θ1 and Θ2) separating the three phases of the curve and corresponding slope values. The method was tested for three economically important woody species. For all species, midday Ψ was much more negative than predawn Ψ during phase I (mild drought), reductions in midday Ψ were minor while predawn Ψ continued to decline during phase II (moderate drought), and midday and predawn Ψ reached similar values during phase III (severe drought). Corresponding measurement of leaf gas exchange indicated that boundary Θ1 between phases I and II coincided with Ψ at stomatal closure. Data from pressure-volume curves demonstrated that boundary Θ2 between phases II and III predicted Ψ at leaf turgor loss. The WP curve method described here is an advanced application of the Scholander-type pressure chamber to categorize plant dehydration under drought into three distinct phases and to predict Ψ thresholds of stomatal closure and turgor loss.

Responsible Job Design Based on the Internal Social Responsibility of Local Governments.

Sustainability needs the socially responsible orientation of public institutions, but not only externally. How civil servants and municipal employees consider what local governments do in relation to their internal social responsibility is the main question of this study. Through structural equation modelling and a sample of 294 employees in local governments in a Spanish region (Extremadura), it is demonstrated that responsible job position design, as well as good communication and team building, both have positive and significant effects on the personal identification of employees with the city council. That has been interpreted as the essence of internal social responsibility and the first step for building external social responsibility at the municipal level. Practical implications and future directions are discussed.

The Challenge of Greening Religious Schools by Improving the Environmental Competencies of Teachers.

Even though sacred scriptures emphasize the key role that Creation and respect for living creatures play in all religions, the so-called religious schools seem to show little interest in putting this sacred mandate into effect. To shed light on this subject, this work investigates the role of teachers in the process, focusing on their environmental competencies. Our hypotheses are tested through a structural equation model on a sample of 214 biology and religion teachers from 118 Catholic schools in Spain who voluntary participated in a survey. The research findings confirm that it is crucial that environmental competencies are developed in teachers to enable the greening of schools. Theoretical and practical implications for defining the job training of teachers in religious schools are drawn from the study.

Work-Life Balance in Great Companies and Pending Issues for Engaging New Generations at Work.

The changing nature of employment and work causes new demands in society, such as work-life balance, that has emerged in labor relations as an important aspect of a healthy work environment. In this context, Best Companies to Work for are a reference in caring for their staff, and it is well known that new generations-that frequently use the Internet to be informed-are making their decisions as job seekers by checking and comparing corporate websites. In order to learn from the best companies, but also to discover what could be improved by identifying the gaps, this study observes the current work-life balance practices in the last Best Companies to Work for awarded by Fortune. The main contribution of this work is the development of a weighted index for benchmarking purposes considering the preferences of new generations at work. The study demonstrates that the best companies still report low levels of work-life balance information. The main implication drawn from the study, due the requirements of new generations at work and the rapidly emerging field of e-recruiting, is the need for human resource departments to fit work and personal life in a fluid way, while maintaining a healthy balance. It is also recommended for companies to improve their disclosure of work-life practices on line for attracting talent from Millennials and Generation Z.

In Favour of Regional Diabetes Day Hospitals.

Diabetes mellitus is considered a public health issue worldwide, with a high prevalence. It is a direct cause of death, disability, and high health costs. In addition, it generates a series of complications of variable types and degrees that have frequent negative effects on the quality of life of the people who suffer from it. Efficiency in public health implies a reduction in costs and improvements in citizens' quality of life. With the twofold aim of rationalizing costs and promoting an improvement in the care of people with diabetes, we propose a project: a Diabetes Day Hospital (DDH) in Extremadura (Spain). This involves a new organizational model which has already been implemented in other European regions, generating satisfactory results. This study includes details on the structure and operation of the DDH, as well as the expected costs. The DDH allows for a proper coordination among the parties involved in the monitoring and treatment of the disease, and reduces the costs derived from unnecessary admissions and chronic complications. Results show that efficiency in the regional health system could be improved and a significant amount of money could be saved.

Microstructural brain and multivoxel spectroscopy in very low birth weight infants related to insulin-like growth factor concentration and early growth.

BACKGROUND: Very low birth weight (VLBW) children have higher risk of neurologic disabilities and growth factors are essential for brain maturation. AIM: To assess whether there are differences in neurologic findings, psychometric parameters and microstructural brain morphology in 1-year-old VLBW infants versus term healthy controls and whether these differences are related to hormonal/growth changes. METHODS: Prospective anthropometry, prefeed venous blood sample [insulin, insulin-like growth factor-I (IGF-I), insulin-like growth factor-II (IGF-II), leptin, glucose], neurologic and imaging assessment, at age 1 year in 34 VLBW infants (12 SGA; 10 M) and 10 healthy term controls (5 M). RESULTS: IGF-I concentrations at 1 month of corrected age were 20% lower in SGA versus appropriate for gestational age VLBW (p < 0.02). Gray and white matter volume and fractional anisotropy in 15/27 regions were decreased (p < 0.001). Abnormal spectroscopy was observed in 4 zones in VLBW versus term controls (p < 0.001). Some of these changes were associated with different periods of first-year growth and IGF-I/IGF-II, leptin and HOMA-IR. CONCLUSIONS: VLBW infants show differences in brain volumes and microstructural brain morphology as compared to term controls, changes related to circulating growth factor and anthropometry changes in the first year. This apparent reorganization of the developing brain offers a unique opportunity to investigate the relationship between changes in cortical anatomy, cognitive and social impairments and periods of early growth.

Interrupción aislada de la vena cava inferior / Isolated interruption of the inferior vena cava

El diagnóstico prenatal de la interrupción de vena cava inferior con continuación de la vena ácigos es infrecuente. Su hallazgo nos obligará a descartar la presencia de un síndrome de cardioesplenia o isomerismo, fundamentalmente el isomerismo izquierdo o poliesplenia, ya que la interrupción de vena cava inferior es un excelente marcador de esta afección: se encuentra en un 55-85% de los casos. Sin embargo, también puede corresponder a una malformación vascular aislada, con nula o escasa repercusión en el pronóstico vital del recién nacido, aunque luego no esté exento de posibles complicaciones en el transcurso de su vida adulta (AU)

The prenatal diagnosis of interruption of the inferior vena cava with azygos vein continuation is uncommon. Its finding will require us to rule out the presence of a cardiosplenic syndrome or isomerism, particularly left isomerism or polysplenia, as interruption of the inferior vena cava is an excellent marker of this disease, being found in 55-85% of cases. However, it can also correspond to an isolated vascular malformation, with no or little effect on the prognosis, essential in the newborn. Although there could be complications later on during their adult life (AU)

Ala54Thr polymorphism of the fatty acid-binding protein 2 gene (intestinal-type FABP) is associated with changes in insulin sensitivity in SGA pubertal girls.

INTRODUCTION: Associations between FABP2 Ala54Thr polymorphism and increased fasting insulin concentration, fasting fatty acid oxidation and reduced glucose uptake have been identified in several populations. The aim of this study was to evaluate the association of Ala54 Thr polymorphism of the FABP2 gene with insulin sensitivity in pubertal girls born small for gestational age (SGA). RESULTS: The frequency of the Thr54 allele did not differ between AGA and SGA girls (0.52 vs 0.43). Girls born SGA positive for the Ala/Thr polymorphism were older at the beginning of puberty compared to girls born AGA with the Thr54 allele (p < 0.01). These girls had lower whole body insulin sensitivity index (WBISI) (4.1 +/- 1.7 vs 9.2+/-7.4, p < 0.05), higher leptin (17.3 +/- 5.9 vs 12.1 +/- 13.7, p < 0.02), insulin area under the curve (AUC) (64,272 +/- 9,209 vs 27,981 +/- 15,637, p < 0.001), proinsulin (17.3 +/- 5.4 vs 10.9 +/- 3.6, p < 0.01) and insulinogenic index (4.6 +/- 3.0 vs 2.9 +/- 5.9, p < 0.01). Conversely, girls born SGA positive for the Ala/Thr polymorphism were older at the beginning of puberty (ns) compared to girls born SGA positive for the Ala/Ala polymorphism. These girls had higher insulin AUC (64,272 +/- 9,209 vs 33,322 +/-7,533, p < 0.01), insulinogenic index (4.6 +/- 3.0 vs 2.5 +/- 3.6, p < 0.01) and lower WBISI (4.1 +/- 1.7 vs 6.3 +/- 1.8, p < 0.05). DISCUSSION: Our results suggest that the Thr54 variant of the FABP2 gene could be associated with a synergic effect in the SGA group regarding higher leptin levels (p < 0.05), lower insulin sensitivity by WBISI (p < 0.05) and higher insulin secretion determined by higher insulinogenic index (p < 0.01), insulin AUC (p < 0.01) and beta-cell stress measured by higher proinsulin (p < 0.05). Our data suggest an involvement of genetic factors in the insulin resistance associated with reduced fetal growth and strengthen the hypothesis that this association could be the consequence of interactions between detrimental factors during fetal life and genetic susceptibility.

Edad de la menarquia y su relación con el nivel socioeconómico e índice de masa corporal / Age of menarche and its relationship with body mass index and socioeconomic status

Background: A decline in the age of menarche was observed from early 1900s to the 1970s. However, it is not known if a further decline ocurred thereafter. Aim: To evaluate the age of menarche in girls from Santiago, Chile and its relationship with body mass index (BMI) and socioeconomic status. Material and Methods: We studied 1302 healthy girls aged 7 to 19 years. Age of menarche was evaluated through a questionnaire to the patient and her parents. Kaplan-Meier curves were used to determine age of menarche and Cox regression analysis was employed to evaluate the effect of the type of school and BMI on the age of menarche. Results: The mean age at menarche was 12.7±0.04 years. Girls from public and private schools had their period at 12.5±0.1 and 13.05±0.05 years respectively. A negative correlation between z scores for BMIand age of menarche was observed (r-0.3: p =0.001). Girls whose menarche occurred before 11.5 years had higher z scores for BMI and a larger proportion were overweight, compared to girls who had menarche later. Cox regression analysis showed that after adjusment for BMI, age of menarche was similar in both types of schools. Conclusions: Age of menarche is ocurring three months earlier in girls from public schools, which is associated with higher z scores for BMI. Type of school, a marker of socio-economic status in Chile, affects timing of menarche due to differences in body mass index.

[Age of menarche and its relationship with body mass index and socioeconomic status]. / Edad de la menarquia y su relación con el nivel socioeconómico e índice de masa corporal.

BACKGROUND: A decline in the age of menarche was observed from early 1900s to the 1970s. However, it is not known if a further decline occurred thereafter. AIM: To evaluate the age of menarche in girls from Santiago, Chile and its relationship with body mass index (BMI) and socioeconomic status. MATERIAL AND METHODS: We studied 1302 healthy girls aged 7 to 19 years. Age of menarche was evaluated through a questionnaire to the patient and her parents. Kaplan-Meier curves were used to determine age of menarche and Cox regression analysis was employed to evaluate the effect of the type of school and BMI on the age of menarche. RESULTS: The mean age at menarche was 12.7+/-0.04 years. Girls from public and private schools had their period at 12.5+/-0.1 and 13.05+/-0.05 years respectively. A negative correlation between z scores for BMI and age of menarche was observed (r-0.3: p =0.001). Girls whose menarche occurred before 11.5 years had higher z scores for BMI and a larger proportion were overweight, compared to girls who had menarche later. Cox regression analysis showed that after adjustment for BMI, age of menarche was similar in both types of schools. CONCLUSIONS: Age of menarche is occurring three months earlier in girls from public schools, which is associated with higher z scores for BMI. Type of school, a marker of socio-economic status in Chile, affects timing of menarche due to differences in body mass index.

Validación: se necesitan instrumentos fiables. Escala de actitud y encuesta de opinión / Verification: reliable instruments needed. Attitude scale and opinion poll

La utilización del método cientifico, en la investigación en enfermerfa, requiere evitar en todo momento la subjetividad. Recogemos datos a través de los instrumentos, que deben ser operativos, válidos y fiables. Se desarrollan y validan dos instrumentos: una encuesta de opinión de 9 preguntas, mediante tests-retests y con una concordancia de proporciones del 93,40%; y una escala de actitud tipo Likert, aplicando la «t» de Student a 59 proposiciones iniciales, recogiendo la escala definitiva con 7 ftems positivos y 7 negativos con significación estadfstica al nivefde confianza del 95%, para una prueba bilateral y con 22 grados de libertad. El trabajo se llevó a cabo mediante un grupo piloto de 43 enfermeras, como ejercicio práctico del taller sobre investigación en enfermerfa celebrado en el Hospital, organizado por la Dirección de Enfermerfa e impartido por el coordinador del grupo

The use of the scientific method in research and investigation in nursing requires avoiding subjectivity at all times. Professionals obtain data by means of instruments which must be operative, valid and reliable. The authors develop and verify two instruments: a nine question opinion poli which uses tests and retests, having a 93-40% concordance proportion. A Likert type attitude scale, applying the «t» in Student to 59 initial propositions, obtaining a definitive scale having 7 positive items and 7 negative ones which gave a 95% confidence 1evel of statistical meaning for a bilateral test and which had 22 degrees-of liberty. This study took place using a pilot group of 43 nurses; it was a practical shop exercise on research in nursing occurred in the Hospital, organized by the Nursing Administration and taught by the group coordinator

[Persistent neonatal hyperinsulinism. Analysis of the differential diagnosis. Report of two cases]. / Hiperinsulinismo neonatal persistente. Análisis del diagnóstico diferencial a propósito de dos casos clínicos.

Persistent neonatal hyperinsulinism is the most common cause of refractory hypoglycemia during the first year of life. Inadequate insulin secretion is associated to mutations of four different genes, that can be diagnosed to orient patient management. We report two patients: a female newborn that presented a hypoglycemia of 16 mg/dl two hours after birth, was subjected to a subtotal pancreatectomy that did not correct hypoglycemia, requiring a total pancreatectomy. Pathological study of the pancreas showed a focal adenomatous hyperplasia. At the present time, she is three years of age and maintains euglycemia with fractionated feeding. A male newborn that had seizures at 28 hours of life and a hypoglycemia of 15 mg/dl was detected. He was also subjected to a subtotal pancreatectomy, that did not correct hypoglycemia and bad to be extended to a total pancreatectomy. At the present time, he is 3 years and 11 months of age and has a normal psychomotor development.

[Acute suppurative thyroiditis. Report of a pediatric case]. / Tiroiditis aguda supurada en un paciente pediátrico.

Acute suppurative thyroiditis (AST) is an uncommon condition because thyroid gland is remarkably resistant to infections. In children, anatomic defects such as a left pyriform sinus fistula or a thyroglossal duct remnant predispose to this infection. Once the diagnosis is confirmed by ultrasound or computed tomography, antimicrobial therapy based on the culture and Gram staining must be started. After two or three weeks of treatment, predisposing anatomic defects must be sought cautiously. We report a 13 year old girl presenting with cervical pain and fever. A cervical ultrasound showed an enlarged thyroid lobule with hypoecogenic zones that suggested a supurative collection. Cefotaxime and cloxacillin were started. A needle aspiration of the collection obtained a purulent material. The culture of this material yielded a Streptococcus Pneumoniae. The clinical condition of the patient improved and she was discharged in good conditions. Two months later a contrast esophagus X ray did not show predisposing anatomic defects.

Atención de enfermería en la espera de las urgencias hospitalarias. Volumen asistencial y cuidados de los pacientes aparcados / Nursing care in emergencies waiting rooms

Los servicios hospitalarios de urgencias se ven a menudo saturados por la gran demanda de asistencia. Al ser insuficientes las instalaciones destinadas a prestar cuidados, los pacientes quedan relegados en muchas ocasiones a ser atendidos en los pasillos. El objetivo de este trabajo es contabilizar el volumen asistencial y los cuidados que reciben estos pacientes, que habitualmente denominamos pacientes aparcados. Se realizó un estudio descriptivo prospectivo en el servicio de urgencias del Hospital Universitario de Granada. Durante dos meses se incluyeron pacientes que después de ser atendidos en una consulta, permanecieron en espera en el pasillo de las urgencias por alguna circunstancia. Los resultados han permitido realizar una estimación de más de cinco mil pacientes a los que afecta este problema, lo que supone un importante número de horas de atención de enfermería que se les presta a estos pacientes, aunque no en el modo y forma que el personal desearía. El hecho de no quedar constancia escrita de estos cuidados, alerta sobre la dificultad para garantizarla continuidad en tratamientos y cuidados, ya que el trabajo del enfermero resulta invisible, con las consecuencias legales que de ello se pueden desprender (AU)