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Consumers' familiarity with foods influences their expectations and experiences upon consumption. Familiarity has mostly been assessed using perceived familiarity when studying single foods. However, foods are often combined to create dishes, complex compositions eaten at various mealtimes. Hence, this paper aimed to study if and how the level of consumers' dish familiarity shapes their motives and preferred contexts for home cooking and consuming three dishes: one traditional dish, one adopted ethnic dish, and one mainly unavailable and unknown ethnic dish. First, we describe the operationalization of familiarity into the qualitative "consumer's dish familiarity index" (CDFI) used to determine participants' familiarity level to the dishes. CDFI includes four indicators (perceived availability, consumer's knowledge, preparation, and consumption). In-depth interviews (n = 27) were conducted with Dutch and Chilean women, as the countries have contrasting levels of immigration and globalization, which are expected to shape their inhabitants' familiarity level with ethnic dishes. Most experienced consumers (high familiarity) mentioned more dishes and individual-related motives to prepare and consume a traditional or an adopted ethnic dish. Social- and individual-related motives were salient when a dish was unknown and/or not previously consumed. Consumers' familiarity level also guided their preferred social context and location when consuming the dishes. A dish barely available will likely be first consumed in a restaurant to try a new dish that is perceived as appetizing to eat. Results showed that convenience, wanting to eat comfort foods, and showing affection to others are important motivators to facilitate the adoption of dishes to be home cooked. PRACTICAL APPLICATION: This paper provides a novel approach to assess consumer familiarity to dishes. The qualitative consumer's dish familiarity index (CDFI) can be used in future investigations to assess and classify consumers into different dish familiarity levels by using four indicators. The outcomes of this study suggest consumers' familiarity level could serve as a reference for designing and/or improving (ethnic) foods and creating marketing campaigns to introduce them into (foreign) countries.
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ABSTRACTRat hepatitis E virus (ratHEV) is an emerging cause of acute hepatitis of zoonotic origin. Since seroprevalence studies are scarce, at-risk groups are almost unknown. Because blood-borne infections frequently occur in people with drug use, who are particularly vulnerable to infection due to lack of housing and homelessness, this population constitutes a priority in which ratHEV infection should be evaluated. Therefore, the aim of this study was to evaluate the ratHEV seroprevalence and RNA detection rate in drug users as a potential at-risk population. We designed a retrospective study involving individuals that attended drug rehabilitation centres. Exposure to ratHEV was assessed by specific antibody detection using ELISA and dot blot (DB) assay and the presence of active infection by ratHEV RNA detection using RT-qPCR. Three-hundred and forty-one individuals were included, the most of them being men (67.7%) with an average age of 45 years. A total of 17 individuals showed specific IgG antibodies against ratHEV (4.6%; 95% CI; 3.1%-7.9%). One case of active ratHEV infection was identified (0.3%; 95% CI: 0.1%-1.8%). This was a 57-year-old homeless woman with limited financial resources, who had active cocaine and heroin use via parenteral route. In conclusion, we identified a potential exposure to ratHEV among drug users. Targeted studies in drug users with proper control groups are necessary to evaluate high-risk populations and transmission routes more accurately.
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Usuários de Drogas , Vírus da Hepatite E , Hepatite E , Humanos , Pessoa de Meia-Idade , Hepatite E/epidemiologia , Hepatite E/virologia , Hepatite E/veterinária , Masculino , Feminino , Estudos Soroepidemiológicos , Adulto , Estudos Retrospectivos , Vírus da Hepatite E/imunologia , Vírus da Hepatite E/genética , Vírus da Hepatite E/isolamento & purificação , RNA Viral/sangue , Anticorpos Anti-Hepatite/sangue , Animais , Imunoglobulina G/sangue , Adulto Jovem , RatosRESUMO
Lucía Vivanco Muñoz es terapeuta ocupacional, egresada de la Universidad de Chile en 1983 y una de las primeras en incursionar en la Terapia Ocupacional social y comunitaria en Chile. En esta entrevista, realizada por su colega Débora Grandón, analiza el desarrollo de la Terapia Ocupacional social y comunitaria a través de su incursión, a finales de la década de 1980 y durante los años 90, en áreas no tradicionales de la Terapia Ocupacional, como el acompañamiento a personas viviendo con VIH-SIDA, la desinstitucionalización de niñeces vulneradas y la reinserción en sus familias y comunidades. También, colaboró en el diseño de políticas públicas para la superación de la pobreza desde el Estado chileno y en otros países, en su rol de consultora para el Banco Mundial. Actualmente, es académica de la Escuela de Terapia Ocupacional en la Universidad de Santiago de Chile -USACH. Esta experiencia como iniciadora de áreas de práctica hoy instituidas en el ejercicio de la profesión tiene un relevante valor histórico y constituye un aporte significativo al desarrollo de estos campos y a la formación de nuevas generaciones.
Lucía Vivanco Muñoz is an occupational therapist who graduated from the University of Chile in 1983 and is one of the pioneers in the development of a social and community Occupational Therapy in Chile. In this interview, conducted by her colleague Débora Grandón, she analyzes the development of a social and community Occupational Therapy throughout her involvement at the end of the 1980s and during the 1990s in non-traditional areas such as accompanying people living with HIV/AIDS, the deinstitutionalization of vulnerable children, and their reintegration into their families and communities. She also participated in designing public policies for overcoming poverty within the Chilean government and other countries in her role as a consultant for the World Bank. She is currently an academic at the School of Occupatio-nal Therapy at the University of Santiago de Chile -USACH. This experience as an initiator of areas of practice established today in the exercise of the profession has a relevant historical value and constitutes a significant contribution to the development of these fields and the training of new generations
Lucía Vivanco Muñoz é terapeuta ocupacional, formada pela Universidade do Chile em 1983, e uma das primeiras a se aventurar na Terapia Ocupacional social e comunitária no Chile. Nesta entrevista, conduzida por sua colega Débora Grandón, se analisa o desenvolvimento da Terapia Ocupacional social e comunitária por meio de sua incursão no final dos anos 80 e durante os anos 90, em áreas não tradicionais da Terapia Ocupacional, como o acompanhamento de pessoas vivendo com HIV-AIDS, a desinstitucionalização de crianças em situação de vulnerabilidade e a reintegração em suas famílias e comunidades. Além disso, colaborou no desenho de políticas públicas para a superação da pobreza no Estado chileno e em outros países, atuando como consultora para o Banco Mundial. Atualmente, é professora na Escola de Terapia Ocupacional da Universidade de Santiago do Chile - USACH. A experiência da professora como pioneira em áreas de prática, hoje instituídas no exercício da profissão, tem um valor histórico relevante e constitui uma contribuição significativa para o desenvolvimento desses campos e para a formação de novas gerações
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Humanos , Apoio Social , História , HIVRESUMO
Two of 11 children with acute hepatitis of unknown origin were found to have rat hepatitis E virus infection. This infection should be considered in the differential diagnosis of children with acute hepatitis of unknown origin.
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We identified rat hepatitis E virus (HEV) RNA in farmed pigs from Spain. Our results indicate that pigs might be susceptible to rat HEV and could serve as viral intermediaries between rodents and humans. Europe should evaluate the prevalence of rat HEV in farmed pigs to assess the risk to public health.
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Vírus da Hepatite E , Humanos , Ratos , Animais , Suínos , Espanha/epidemiologia , Vírus da Hepatite E/genética , Europa (Continente) , Fazendas , Saúde Pública , RNARESUMO
Continuous immunosuppression after organ transplantation is associated with an increased risk of developing keratinocyte neoplastic lesions. Topical photodynamic therapy represents a therapeutic approach for different keratinocyte neoplastic lesions. However, the specific efficacy and safety of this treatment in this immunocompromised population remains largely unknown. In this case report series, we show the efficacy and safety of photodynamic therapy with BF-200 ALA gel using red-light and daylight in immunocompromised patients. Out of 8 patients presented here, 1 was treated for 8 basal cell carcinomas, 1 for 2 Bowen´s disease lesions and 6 were treated for field cancerization including 4 to 10 actinic keratoses. Treatment response rates were above 75 %. The adverse events, including pain, did not differ from those already described for PDT. These data suggest that PDT with BF-200 ALA gel could be an effective and safe option to add to the treatment portfolio for neoplastic keratinocyte lesions in this high-risk population.
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Ácido Aminolevulínico/análogos & derivados , Doença de Bowen , Carcinoma Basocelular , Ceratose Actínica , Transplante de Órgãos , Fotoquimioterapia , Neoplasias Cutâneas , Humanos , Ceratose Actínica/tratamento farmacológico , Doença de Bowen/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Hospedeiro Imunocomprometido , Carcinoma Basocelular/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológicoRESUMO
INTRODUCTION: The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. MATERIAL AND METHODS: We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). RESULTS: In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DISCUSSION: Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.
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Dermatite Atópica , Molusco Contagioso , Dermatopatias , Neoplasias Cutâneas , Verrugas , Criança , Humanos , Estudos Transversais , Dermatite Atópica/terapia , Molusco Contagioso/terapia , Qualidade de Vida , Dermatopatias/terapiaRESUMO
Introducción: Las enfermedades cutáneas pueden afectar a la calidad de vida de forma muy variable; el impacto de algunas dermatosis puede ser similar al del asma o la fibrosis quística. Material y métodos: Realizamos un estudio observacional, descriptivo y transversal con el objetivo de describir el grado de afectación de la calidad de vida de los niños que acudieron a la consulta monográfica de Dermatología Pediátrica, mediante el Children's Dermatology Life Quality Index (CDLQI). Resultados: En este estudio la dermatosis con mayor impacto en la calidad de vida fue la dermatitis atópica, debido principalmente a síntomas como el prurito y el insomnio. El segundo grupo diagnóstico con mayor afectación fue el acné, debido principalmente a los sentimientos negativos (vergüenza, tristeza, etc.) asociados al mismo. Los pacientes con verrugas víricas y moluscos contagiosos tuvieron impacto en la calidad de vida debido principalmente al tratamiento de los mismos, que se realizó principalmente con crioterapia. La mayor parte de los pacientes con nevus o manchas café con leche no tuvieron afectación en la calidad de vida, si bien hasta un tercio de ellos tuvieron sentimientos negativos secundarios a su dermatosis. Discusión: La dermatitis atópica fue la enfermedad dermatológica común que más impactó en la calidad de vida en nuestra muestra de pacientes, aunque otros procesos también afectaron a la calidad de vida en distintos aspectos de la misma. Cabe destacar la recomendación de emplear en verrugas víricas y moluscos contagiosos tratamientos más indoloros que la crioterapia, ya que es el tratamiento lo que más impacta en la calidad de vida de los pacientes pediátricos. (AU)
Introduction: The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. Material and methods: We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). Results: In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. Discussion: Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment. (AU)
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Humanos , Masculino , Feminino , Criança , Adolescente , Qualidade de Vida , Dermatopatias , Estudos Transversais , Epidemiologia Descritiva , Espanha , Dermatite Atópica , Acne Vulgar , VerrugasRESUMO
OBJECTIVES: Evidence on the effectiveness of remdesivir when used in real-life clinical practice is controversial. This study aims to analyse its effectiveness and the factors associated with increased mortality in non-critically ill patients with COVID-19 pneumonia who require supplemental low-flow oxygen and received remdesivir. METHODS: A retrospective cohort study was conducted at Ramón y Cajal University Hospital (Madrid, Spain) which included all patients treated with remdesivir in our institution during the second pandemic breakout in Spain, from August to November 2020. Treatment with remdesivir was limited to non-critically ill patients with COVID-19 pneumonia requiring low-flow supplemental oxygen, with a treatment duration of 5 days. RESULTS: A total of 1757 patients were admitted with COVID-19 pneumonia during the study period, of which 281 non-critically ill patients were treated with remdesivir and included in the analysis. Mortality at 28 days after initiation of treatment was 17.1%. The median (IQR) time to recovery was 9 days (6-15). 104 (37.0%) patients had complications during hospitalisation, with renal failure being the most frequent (31 patients; 36.5%). After adjustment for confounding factors, high-flow oxygen therapy was associated with increased 28-day mortality (HR 2.77; 95% CI 1.39 to 5.53; p=0.004) and decreased 28-day clinical improvement (HR 0.54; 95% CI 0.35 to 0.85; p=0.008). A significant difference in survival and clinical improvement was identified between patients treated with high and low-flow oxygen. CONCLUSION: The 28-day mortality rate in patients treated with remdesivir needing low-flow oxygen therapy was higher than that published in clinical trials. Age and increased oxygen therapy needed after the beginning of treatment were the main risk factors associated with mortality.
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Background: Sustained social withdrawal is a key indicator of child emotional distress and a risk factor for psychological development. Preterm infants have a higher probability of developing sustained social withdrawal than infants born full-term during their first year. Objective: To compare the effect of a behavioral guidance intervention to that of routine pediatric care on sustained social withdrawal behavior in preterm infants. Design: Multicenter randomized clinical trial. Participants: Ninety nine moderate and late preterm newborns and their parents were recruited and randomized into two groups, i.e., Intervention (n = 49) and Control (n = 50). Both groups attended medical check-ups at 2, 6 and 12 months and were assessed with the Alarm Distress Baby Scale. The intervention group received a standardized behavioral intervention if the neonatologist detected sustained social withdrawal. Also, parents filled out the Edinburgh Postnatal Depression Scale, the modified-Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale-revised. Results: At baseline, the prevalence of withdrawal was 4.0% (95% CI: 0.03-14.2) for the control group and 22.4% (95% CI: 13.0-35.9) for the intervention group [OR = 0.22, p = 0.028 (95% CI =0.06-0.84)]. At 6 months, the prevalence was 10.0% (95% CI: 3.9-21.8) for the control group and 6.1% (95% CI: 2.1-16.5) for the intervention group [OR = 2.09, p = 0.318 (95% CI = 0.49-8.88)]. At 12 months, the prevalence was 22.0% (95% CI: 12.8-35.2) for the control group and 4.1% (95% CI: 1.1-13.7) for the intervention group [OR = 6.63, p = 0.018 (95% CI = 1.39-31.71)]. Logistic generalized estimating equation models were performed. The pooled crude OR (considering diagnosis at 6 and 12 months) was 3.54 [p = 0.022 (95% CI = 1.20-10.44); Cohen's d= 0.70]. In the case of pooled adjusted OR, the model considered diagnosis (0 = Withdrawal, 1 = Normal) as the dependent variable, time of evaluation (1= 6 months, 2 = 12 months) and group (0 = Control, 1 = Experimental) as factors. In this case, the pooled adjusted OR was 3.57 [p = 0.022 (95% CI = 1.20-10.65); Cohen's d = 0.70]. Conclusion: Assessment and intervention of sustained social withdrawal in preterm infants via standardized instruments benefits families by reducing its prevalence, and possible associated negative outcomes. Clinical Trial Registration: ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT03212547, identifier: NCT03212547.
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During the first hours after stroke onset, neurological deficits can be highly unstable: some patients rapidly improve, while others deteriorate. This early neurological instability has a major impact on long-term outcome. Here, we aimed to determine the genetic architecture of early neurological instability measured by the difference between the National Institutes of Health Stroke Scale (NIHSS) within 6â h of stroke onset and NIHSS at 24â h. A total of 5876 individuals from seven countries (Spain, Finland, Poland, USA, Costa Rica, Mexico and Korea) were studied using a multi-ancestry meta-analyses. We found that 8.7% of NIHSS at 24â h of variance was explained by common genetic variations, and also that early neurological instability has a different genetic architecture from that of stroke risk. Eight loci (1p21.1, 1q42.2, 2p25.1, 2q31.2, 2q33.3, 5q33.2, 7p21.2 and 13q31.1) were genome-wide significant and explained 1.8% of the variability suggesting that additional variants influence early change in neurological deficits. We used functional genomics and bioinformatic annotation to identify the genes driving the association from each locus. Expression quantitative trait loci mapping and summary data-based Mendelian randomization indicate that ADAM23 (log Bayes factor = 5.41) was driving the association for 2q33.3. Gene-based analyses suggested that GRIA1 (log Bayes factor = 5.19), which is predominantly expressed in the brain, is the gene driving the association for the 5q33.2 locus. These analyses also nominated GNPAT (log Bayes factor = 7.64) ABCB5 (log Bayes factor = 5.97) for the 1p21.1 and 7p21.1 loci. Human brain single-nuclei RNA-sequencing indicates that the gene expression of ADAM23 and GRIA1 is enriched in neurons. ADAM23, a presynaptic protein and GRIA1, a protein subunit of the AMPA receptor, are part of a synaptic protein complex that modulates neuronal excitability. These data provide the first genetic evidence in humans that excitotoxicity may contribute to early neurological instability after acute ischaemic stroke.
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Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Teorema de Bayes , Isquemia Encefálica/complicações , Isquemia Encefálica/genética , Estudo de Associação Genômica Ampla , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/genética , Estados UnidosRESUMO
The Central-South Chile margin is an excellent site to address the changes in the gas hydrate system since the last deglaciation associated with tectonic uplift and great earthquakes. However, the dynamic of the gas hydrate/free gas system along south central Chile is currently not well understood. From geophysical data and modeling analyses, we evaluate gas hydrate/free gas concentrations along a seismic line, derive geothermal gradients, and model past positions of the Bottom Simulating Reflector (BSR; until 13,000 years BP). The results reveal high hydrate/free gas concentrations and local geothermal gradient anomalies related to fluid migration through faults linked to seafloor mud volcanoes. The BSR-derived geothermal gradient, the base of free gas layers, BSR distribution and models of the paleo-BSR form a basis to evaluate the origin of the gas. If paleo-BSR coincides with the base of the free gas, the gas presence can be related to the gas hydrate dissociation due to climate change and geological evolution. Only if the base of free gas reflector is deeper than the paleo-BSR, a deeper gas supply can be invoked.
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Malformações Arteriovenosas , Telangiectasia Hemorrágica Hereditária , Adolescente , Feminino , Mãos , Humanos , Lábio , Extremidade SuperiorRESUMO
The Chile Triple Junction, where the hot active spreading centre of the Chile Rise system subducts beneath the South American plate, offers a unique opportunity to understand the influence of the anomalous thermal regime on an otherwise cold continental margin. Integrated analysis of various geophysical and geological datasets, such as bathymetry, heat flow measured directly by thermal probes and calculated from gas hydrate distribution limits, thermal conductivities, and piston cores, have improved the knowledge about the hydrogeological system. In addition, rock dredging has evidenced the volcanism associated with ridge subduction. Here, we argue that the localized high heat flow over the toe of the accretionary prism results from fluid advection promoted by pressure-driven discharge (i.e., dewatering/discharge caused by horizontal compression of accreted sediments) as reported previously. However, by computing the new heat flow values with legacy data in the study area, we raise the assumption that these anomalous heat flow values are also promoted by the eastern flank of the currently subducting Chile Rise. Part of the rift axis is located just below the toe of the wedge, where active deformation and vigorous fluid advection are most intense, enhanced by the proximity of the young volcanic chain. Our results provide valuable information to current and future studies related to hydrothermal circulation, seismicity, volcanism, gas hydrate stability, and fluid venting in this natural laboratory.
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Current generations have been strongly influenced by mass communication and massive immigration flows, which may change local lifestyles and perceptions of inhabitants towards traditional foods and beverages (TFBs). TFBs constitute a core element of the cultural identity of a country, although some of them are losing their appeal. In this study, the authors explored the TFBs perceptions of inhabitants in nine countries to determine if their food identity is changing by analysing the TFBs most frequently mentioned by different age cohorts within a country. Six countries were found to have a distinctive core of TFBs shared across age cohorts (homogenous), whereas the remaining showed a heterogeneous pattern. Correspondence and cluster analyses usually grouped younger generations together implying higher similarities among these cohorts. Furthermore, the binary logistic regression analyses performed identified significant differences in the probability of mentioning a specific TFBs across age cohorts per country. Data collected show younger cohorts focusing on TFBs categorised as snacks and foods on-the-go, whereas older cohorts more often refer to time-consuming savoury preparations. The results suggest that lifestyles and current societal trends in food consumption, for example, convenience and healthiness, are impacting the food culture and identity of countries, and therefore play an important role in the variation of TFBs perception and consumption between age cohorts within countries. The results obtained in this study could not only be used by food policymakers and nutritionists to distinguish the current trends that are reshaping the food identity and eating behaviours of the population but also to improve or develop new dietary strategies by age cohorts in the countries studied.
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INTRODUCTION: Studies conducted by various scientific societies have shown that the demand for specialized rheumatology care is greater than the projected growth of the workforce. Our research aims to assess the current status of the rheumatology workforce in Latin America. METHOD: This is a descriptive, cross-sectional study. A survey was created on the RedCap platform. Data were analyzed with STATA 15® Software. We present descriptive analyses. The rate of inhabitants per rheumatologist was calculated using the number of rheumatologists practicing in each country and the inhabitants for year 2020. RESULTS: Our sample was composed by 19 PANLAR member countries in Latin America. Latin America has one rheumatologist per 106,838 inhabitants. The highest rate of rheumatologist per inhabitants was found in Uruguay (1 per 27,426 inhabitants), and the lowest was found in Nicaragua (1 per 640,648 inhabitants). Mean age was 51.59 (SD12.70), ranging between 28 and 96 years of age. Mean monthly compensation was USD $2382.6 (SD$1462.5). The country with lowest salary was Venezuela ($197), whereas the highest was Costa Rica ($4500). CONCLUSIONS: There is a high variability in rheumatologists' workforce characteristics in Latin America. These results could lead to policies aiming to increase the availability and income of rheumatologists, in order to increase opportunity and quality of care of patients living with rheumatic diseases. Key Points ⢠The rheumatologists' workforce varies significantly among Latin American countries. ⢠The supply of rheumatologists is insufficient for meeting the increasing need for specialists in this field.