A Community-Driven Approach to Generate Urban Policy Recommendations for Obesity Prevention.

There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents' perspectives to help understanding how urban environments relate to residents' food choices and physical activity levels. We describe an innovative community-driven process aimed to develop environmental recommendations for obesity prevention. We conducted this study in a low-income area in Madrid (Spain), using a collaborative citizen science approach. First, 36 participants of two previous Photovoice projects translated their findings into policy recommendations, using an adapted logical framework approach. Second, the research team grouped these recommendations into strategies for obesity prevention, using the deductive analytical strategy of successive approximation. Third, through a nominal group session including participants, researchers, public health practitioners and local policy-makers, we discussed and prioritized the obesity prevention recommendations. Participants identified 12 policy recommendations related to their food choices and 18 related to their physical activity. The research team grouped these into 11 concrete recommendations for obesity prevention. The 'top-three' ranked recommendations were: (1) to adequate and increase the number of public open spaces; (2) to improve the access and cost of existing sports facilities and (3) to reduce the cost of gluten-free and diabetic products.

[Infant pain response according to vaccine administration]. / Respuesta al dolor de lactantes según el orden de administración de las vacunas.

OBJECTIVE: To determine if acute pain response in infants after administration of pentavalent diphtheria (polio, tetanus, acellular pertussis and B Type Hemophilus influenzae: Pentavac) and meningitis C vaccine (NeisVacC) vary according to the administration order. METHOD: A multicenter, randomized control trial, double-blind was performed in three pediatric nursing consultations of three healthcare centers between December 2010, and December 2011. Two months healthy children in subjected to a routine immunization. Routine immunizations are given in a different order to children; first NeisVac C and then Pentavac are given to the Group A and first Pentavac and then NeisVac C are given to the Group B. Was measured infant pain during the injection of the vaccine using a validates method, the Modified Behavioral Pain Scale (MBPS). Parents measured pain with the VAS scale and evaluated the presence of tears before the beginning of vaccination. RESULTS: Within the 184 infants, 92 received the A order, and 92 the B order. There were no differences between groups in terms of sociodemographic characteristics. The average (AV) pain scores per infant after receiving injections were significantly lower when Pentavac was administered in a second place in A Group. MBPS 5.6 (SD 1.5) versus NeisVac C 7.6 (SD 1.3) (p = 0.0001), EVA 3.6 Parents (SD) versus 5.4 (DE 1.9) (p = 0.0001). In B Group, the average for Pentavac" BPS pain was 7.6 (SD 1.5) versus 7.9 (DE 1.2) to NeisVac C Parents EVA 5.5 (SD 1.8) versus 6.3 (SD 1.6) (p = 0.004). CONCLUSIONS: Pain was reduced when Pentavac vaccine was administered before NeisVac C in infants subjected to a routine vaccination. It is recommended that the order of injections of the vaccine will be first Pentavac followed by NeisVac C.

Respuesta al dolor de lactantes según el orden de administración de las vacunas / Infant pain response acording to vaccunes administration

Objetivo. Determinar si la respuesta de dolor agudo en lactantes después de la administración de la vacuna pentavalente de la difteria, la poliomielitis, el tétanos, la tosferina acelular y la Haemophilus influenzae tipo b (Pentavac®) y la vacuna contra la meningitis C (NeisVac C®) se ve afectada por el orden de administración. Método. Ensayo clínico, multicéntrico, aleatorizado y doble ciego realizado en tres consultas de enfermería pediátrica de tres Centros de Atención Primaria, entre los meses de diciembre de 2010 y diciembre de 2011. Se incluyen niños sanos de dos meses de edad sometidos a la inmunización rutinaria. Se administran las vacunas rutinarias con un orden distinto en los niños. Grupo A (primero se inyecta NeisVac C® y después Pentavac®), y Grupo B (primero se inyecta Pentavac® y después NeisVac C®). Se midió el dolor del lactante durante la inyección de la vacuna, utilizando un método validado, la Escala de Comportamiento ante el Dolor Modificada o Modified Behavioral Pain Scale (MBPS). Los padres midieron el dolor con la escala EVA y se valoró la presencia de llanto antes del inicio de la vacunación. Resultados. Participaron un total de 184 lactantes: 92 recibieron el orden A y 92 el orden B. No hubo diferencias entre los grupos en cuanto a características sociodemográficas. La media y desviación estándar (DE) de las puntuaciones de dolor por lactante después de recibir las inyecciones fueron significativamente más bajas cuando Pentavac® se administró en el Grupo A en segundo lugar -MBPS 5.6 (DE 1.5)- frente a NeisVac C(R) -MBPS 7.6 (DE 1.3)- (p = 0.0001); EVA Padres 3.6 (DE 2) frente a 5.4 (DE 1.9) (p = 0.0001). En el Grupo B, la media de dolor MBPS para Pentavac® fue de 7.6 (DE 1.5) frente a 7.9 (DE 1.2) para NeisVac C®; EVA Padres 5.5 (DE 1.8) frente a 6.3 (DE 1.6) (p = 0.004). Conclusiones. El dolor se redujo cuando la vacuna Pentavac® se administró antes que NeisVac C® en los lactantes sometidos a la vacunación rutinaria. Se recomienda que el orden de las inyecciones de la vacuna sea primero Pentavac®, seguido por NeisVac C® (AU)

Objective. To determine if acute pain response in infants after administration of pentavalent diphtheria (polio, tetanus, acellular pertussis and B Type Hemophilus influenzae: Pentavac®) and meningitis C vaccine (NeisVacC®) vary according to the administration order. Method. A multicenter, randomized control trial, double-blind was performed in three pediatric nursing consultations of three healthcare centers between December 2010, and December 2011. Two months healthy children in subjected to a routine immunization. Routine immunizations are given in a different order to children; first NeisVac C® and then Pentavac® are given to the Group A and first Pentavac® and then NeisVac C® are given to the Group B. Was measured infant pain during the injection of the vaccine using a validates method, the Modified Behavioral Pain Scale (MBPS). Parents measured pain with the VAS scale and evaluated the presence of tears before the beginning of vaccination. Results. Within the 184 infants, 92 received the A order, and 92 the B order. There were no differences between groups in terms of sociodemographic characteristics. The average (AV) pain scores per infant after receiving injections were significantly lower when Pentavac® was administered in a second place in A Group. MBPS 5.6 (SD 1.5) versus NeisVac C® 7.6 (SD 1.3) (p = 0.0001), EVA 3.6 Parents (SD 2) versus 5.4 (DE 1.9) (p = 0.0001). In B Group, the average for Pentavac® MBPS pain was 7.6 (SD 1.5) versus 7.9 (DE 1.2) to NeisVac C ®. Parents EVA 5.5 (SD 1.8) versus 6.3 (SD 1.6) (p = 0.004). Conclusions. Pain was reduced when Pentavac® vaccine was administered before NeisVac C® in infants subjected to a routine vaccination. It is recommended that the order of injections of the vaccine will be first Pentavac® followed by NeisVac C® (AU)