Caregiver Thrive, Learn, & Connect: Testing the Efficacy of an Online Psychoeducational Program for Family Caregivers.

OBJECTIVES: Research reports that providing care to a relative or friend with a chronic health condition or significant neurocognitive disorders, such as dementia is a demanding job. Caregiving often leads to higher risk for adverse mental health outcomes. In this study, we examine the short-term efficacy of the CaregiverTLC online psychoeducational program to caregivers of adults with chronic health or significant memory troubles. METHOD: Using pre-post data from the CaregiverTLC randomized controlled trial (n = 81) we examined differences between the intervention and control conditions on caregivers' psychosocial outcomes for depressive symptoms, self-efficacy, burden, anxiety, and caregiver gains. RESULTS: Data analyses indicated significant decrease in self-reported depressive symptoms, burden, anxiety, and significant increases in self-efficacy and caregiver gains for caregivers in the active intervention compared to those in the control condition. CONCLUSIONS: These results suggest that regardless of whether caregivers care for a person with a chronic illness or significant neurocognitive disorder, they can benefit from participation in this online psychoeducational program. CLINICAL IMPLICATIONS: The CaregiverTLC program may be an effective method to teach skills to reduce depression, burden, and anxiety, and improve self-efficacy and personal gains among caregivers of older adults with chronic illnesses.

Effects of simulated climate change conditions of increased temperature and [CO2] on the early growth and physiology of the tropical tree crop, Theobroma cacao L.

Despite multiple studies of the impact of climate change on temperate tree species, experiments on tropical and economically important tree crops, such as cacao (Theobroma cacao L.), are still limited. Here, we investigated the combined effects of increased temperature and atmospheric carbon dioxide concentration ([CO2]) on the growth, photosynthesis and development of juvenile plants of two contrasting cacao genotypes: SCA 6 and PA 107. The factorial growth chamber experiment combined two [CO2] treatments (410 and 700 p.p.m.) and three day/night temperature regimes (control: 31/22 °C, control + 2.5 °C: 33.5/24.5 °C and control + 5.0 °C: 36/27 °C) at a constant vapour pressure deficit (VPD) of 0.9 kPa. At elevated [CO2], the final dry weight and the total and individual leaf areas increased in both genotypes, while the duration for individual leaf expansion declined in PA 107. For both genotypes, elevated [CO2] also improved light-saturated net photosynthesis (Pn) and intrinsic water-use efficiency (iWUE), whereas leaf transpiration (E) and stomatal conductance (gs) decreased. Under a constant low VPD, increasing temperatures above 31/22 °C enhanced the rates of Pn, E and gs in both genotypes, suggesting that photosynthesis responds positively to higher temperatures than previously reported for cacao. However, dry weight and the total and individual leaf areas declined with increases in temperature, which was more evident in SCA 6 than PA 107, suggesting the latter genotype was more tolerant to elevated temperature. Our results suggest that the combined effect of elevated [CO2] and temperature is likely to improve the early growth of high temperature-tolerant genotypes, while elevated [CO2] appeared to ameliorate the negative effects of increased temperatures on growth parameters of more sensitive material. The evident genotypic variation observed in this study demonstrates the scope to select and breed cacao varieties capable of adapting to future climate change scenarios.

Diagnóstico y tratamiento de los tumores de la unión esofagogástrica. Experiencia en el Instituto Nacional de Cancerología / Diagnosis and treatment of esophagogastric junction tumors. Experience at the National Cancer Institute

Introducción. El diagnóstico adecuado de los tumores de la unión esofagogástrica es esencial para el tratamiento de estos pacientes. La clasificación propuesta por Siewert-Stein define las características propias, factores de riesgo y estrategias quirúrgicas según la localización. El objetivo de este estudio fue describir las características de los pacientes con adenocarcinoma de la unión esofagogástrica tratados en nuestra institución. Métodos. Estudio retrospectivo, descriptivo, de corte longitudinal, que incluyó los pacientes con diagnóstico de adenocarcinoma de la unión esofagogástrica intervenidos quirúrgicamente en el Instituto Nacional de Cancerología, Bogotá, D.C., Colombia, entre enero de 2012 y mayo de 2017. Resultados. Se operaron 59 pacientes (84,7 % hombres), con una edad media de 62,5 años. En su orden de frecuencia los tumores fueron tipo II (57,6 %), tipo III (30,7 %) y tipo I (11,9 %). El 74,6 % recibieron neoadyuvancia y se realizó gastrectomía total en el 73 % de los pacientes. La concordancia diagnóstica moderada con índice Kappa fue de 0,56, difiriendo con la endoscópica en 33,9 %. El 10,2 % de los pacientes presentó algún tipo de complicación intraoperatoria. La supervivencia a tres años en los tumores tipo II fue del 89,6 % y del 100 % en aquellos con respuesta patológica completa. Conclusión. Es necesario el uso de diferentes estrategias para un proceso diagnóstico adecuado en los tumores de la unión esofagogástrica. En esta serie, los pacientes Siewert II, aquellos que recibieron neoadyuvancia y los que obtuvieron una respuesta patológica completa, tuvieron una mejor supervivencia a tres años

Introduction: Proper diagnosis of gastroesophageal junction tumors is essential for the treatment of these patients. The classification proposed by Siewert-Stein defines its own characteristics, risk factors and surgical strategies according to the location. This study describes the characteristics of patients with adenocarcinoma of the esophagogastric junction treated at our institution. Methods. Retrospective, descriptive, longitudinal study, which includes patients diagnosed with adenocarcinoma of the esophagogastric junction who underwent surgery at the National Cancer Institute in Bogotá, Colombia, between January 2012 and May 2017. Results. Fifty-nine patients (84.7% men) were operated on, with a mean age of 62.5 years. In their order of frequency, the tumors were type II (57.6%), type III (30.7%) and type I (11.9%). 74.6% received neoadjuvant therapy and total gastrectomy was performed in 73% of the cases. The moderate diagnostic concordance with the Kappa index was 0.56, differing from the endoscopic one in 33.9%. 10.2% of the patients presented some type of intraoperative complication. Three-year survival in type II tumors was 89.6% and 100% in those with complete pathologic response. Conclusion. The use of different strategies is necessary for an adequate diagnostic process in tumors of the esophagogastric junction. In this series, Siewert II patients, those who received neoadjuvant therapy, and those who obtained a complete pathological response had a better three-year survival

Exploring the potential of eco-friendly silver nanoparticles to inhibit azole-resistant clinical isolates of Candida spp.

The antimicrobial activity and biological efficiency of silver nanoparticles (AgNps) have been widely described and can be modeled through stabilizing and reducing agents, especially if they exhibit biocidal properties, which can enhance bioactivity against pathogens. The selective action of AgNps remains a major concern. In this regard, the use of plant extracts for the green synthesis of nanoparticles offers advantages because it improves the toxicity of Nps for microorganisms and is harmless to normal cells. However, biological evaluations of the activity of AgNps synthesized using different reducing agents are determined independently, and comparisons are frequently overlooked. Thus, we investigated and compared the antifungal and cytotoxic effects of two ecological AgNps synthesized from Moringa oleifera aqueous leaf extract (AgNp-M) and glucose (AgNp-G) against azole-resistant clinical isolates of Candida spp. and nontumor mammalian cells. Synthesized AgNps exhibited an antifungal effect on planktonic cells of drug-resistant C. albicans and C. tropicalis (MIC 0.21-52.6 µg/mL). The toxicity was influenced by size. However, the use of M. oleifera extracts allows us to obtain AgNps that are highly selective and nongenotoxic to Vero cells due to modifications of the shape and surface. Therefore, these results suggest that AgNp-M has antimicrobial potential and deserves further investigation for biomedical applications.

LGBTQ Incorporated: YouTube and the Management of Diversity.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people use the video-sharing service YouTube to educate and entertain audiences. However, YouTube, a subsidiary of Google, has a fraught history with LGBTQ users. Informed by digital ethnography and content analysis, this paper illustrates the company's strategic incorporation of LGBTQ creators and their video content. On the one hand, I show how YouTube publicly presents LGBTQ people's diversity in terms of race, ethnicity, nationality, gender, sexuality, and mental health status. On the other hand, the platform privately discriminates against LGBTQ users creating content about queer sex education, lesbian sexuality, and transgender identity-topics in conflict with advertising and community guidelines. YouTube's discriminatory practices (closely tied to automated algorithms) include demonetization, age restriction, video deletion, account termination, and harassment facilitation. Ultimately, this paper cautions against uncritical celebrations of social media industries' recognition of the LGBTQ community.

Indicadores antropométricos y patrones alimentarios en estudiantes universitarios / Anthropometric indicators and eating patterns in university students

OBJETIVO: Algunas investigaciones realizadas en comunidades universitarias alrededor del mundo, muestran como durante esta etapa se presentan cambios significativos frente a los estilos y dinámicas de vida los estudiantes. En este estudio se identificaron indicadores antropométricos y patrones alimentarios que caracterizan a los estudiantes universitarios de la Facultad de Ciencias de la Nutrición y los Alimentos de la Universidad CES (Colombia) en el período 2018 y 2019. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional y descriptivo, con datos provenientes de fuentes de información secundarias donde reposaba la información de los indicadores antropométricos y patrones alimentarios de los estudiantes durante el periodo en mención, las cuales fueron revisadas el primer semestre del año 2022. RESULTADOS: Tomando en cuenta el indicador de índice de masas corporal (IMC) de los evaluados, el 2,7% presento obesidad, el 18,3% sobrepeso, el 72,3 % adecuación, el 6,2 % bajo peso y un 0,4% bajo peso severo. Se encontró que los alimentos de mayor consumo diario fueron cereales refinados, raíces, plátanos y tubérculos, verduras, lácteos reducidos en grasa, carnes magras, huevos, grasas de origen vegetal y azúcares. Respecto a los alimentos con mayor consumo ocasional o sin consumo, se encuentran los cereales integrales, lácteos enteros, carnes altas en grasas, grasa de origen animal y claras de huevo. CONCLUSIONES: resultados develan que la mayor parte de los investigados reflejo un IMC normal y un menor porcentaje evidencian problemas asociados con la malnutrición, un 6,6 % presentó déficit de peso, mientras que un 21,0% presento exceso de peso, a la par se observan patrones alimentarios protectores como un elevado porcentaje de consumo diario de frutas, verduras, carnes magras, grasas de origen vegetal y consumo ocasional o no consumo de lácteos enteros, carnes altas en grasa y grasa de origen animal.

OBJECTIVE: Some investigations carried out in university communities around the world show how during this stage significant changes are presented regarding the styles and dynamics of life of the students. In this study, anthropometric indicators and eating patterns that characterize university students of the Faculty of Nutrition and Food Sciences of the CES University in the period 2018 and 2019 were identified. MATERIALS AND METHODS: Retrospective, observational and descriptive study, with data from secondary information sources where the information on the anthropometric indicators and eating patterns of the students rested during the period in question, which were reviewed the first semester of 2022. RESULTS: Taking into account the mass index indicator (BMI) of those evaluated, 2,7% present obesity, 18,3% overweight, 72,3% adequacy, 6,2% underweight and 0,4% severe underweight. It was found that the foods with the highest daily consumption were refined cereals, roots, bananas and tubers, vegetables, reduced-fat dairy products, lean meats, eggs, fats of vegetable origin, and sugars. Regarding foods with greater occasional consumption or without consumption, there are whole grains, whole milk products, high-fat meats, fat of animal origin and egg whites. CONCLUSIONS: the results reveal that the majority of those investigated reflect a normal BMI and a lower percentage show problems associated with malnutrition, 6.6% presented weight deficit, while 21,0% presented excess weight, at the same time they are observed protective food patterns such as a high percentage of daily consumption of fruits, vegetables, lean meats, fats of vegetable origin and occasional consumption or non-consumption of full-fat dairy products, meats high in fat and fat of animal origin.

A Proactive Behavioral Activities Program (EWA) and the Influence of COVID-19 among Seniors in Congregate Living Communities.

Older adults in affordable housing are at risk for mental health problems, physical vulnerability, and isolation. We examine the role of an activities program in buffering the influence of life stressors on the mental health of seniors in congregate housing, using a non-experimental pretest-posttest study design. Results based upon repeated measures analyses (N = 29), found statistically significant (p < .05) program by time effects for depression, coping strategies, positive affect, isolation, and resident satisfaction. Analyses based upon independent samples of pretest and posttest measures (N = 60) were considerably less strong, but consistent in yielding similar patterns to those of the longitudinally gathered data. Our longitudinal findings substantiate the positive impact of the Engage with Age program in supporting older adults living in congregate housing. Researchers need to develop strategies to assess and support the mental health of older persons in low-income urban congregate living in the larger context of COVID-19.

Endoscopic negative pressure therapy for the closure of an esophagojejunal anastomosis fistula. Case report / Terapia endoscópica de presión negativa para cierre de fístula de la anastomosis esófago-yeyunal. Reporte de caso

Abstract Introduction: Post-surgical esophagojejunal anastomosis fistulas can be life-threatening. Currently, there are several treatment alternatives. In recent years, endoscopic negative pressure therapy has emerged as an innovative treatment for these fistulas, offering numerous benefits. Case presentation: A 72-year-old man diagnosed with gastric adenocarcinoma of the body and fundus underwent total gastrectomy with D2 lymphadenectomy and Roux-en-Y anastomosis with curative intent in a quaternary care hospital in Popayán, Colombia. However, in the postoperative period, he presented systemic inflammatory response syndrome and acute abdomen due to an esophagojejunal fistula. Initial management included a laparotomy, two peritoneal washings, and an abdominal drainage. Then the patient developed frozen abdomen, so it was not possible to access the esophagojejunal anastomosis. Fistula closure was attempted by inserting a self-expandable metallic stent, yet the procedure was not successful. Salvage therapy was started using an endoscopic vacuum-assisted closure (VAC) system. After 5 replacements of the VAC system, complete drainage of the intra-abdominal collection, complete closure of the peritoneal cavity, and closure of the esophagojejunal leak, with a small residual diverticular formation, were achieved. The patient's condition improved progressively, resuming oral intake 20 days after initiation of VAC therapy. In addition, no new abdominal complications were reported during the follow-up period (17 months). Conclusions: Endoscopic VAC therapy is a new safe and effective alternative to treat complex post-surgical fistulas caused by esophagojejunal anastomosis.

Resumen Introducción. Las fístulas de las anastomosis esófago-yeyunales postquirúrgicas pueden llegar a ser mortales. En la actualidad, existen varias alternativas de tratamiento, y en los últimos años la terapia endoscópica de presión negativa se ha convertido en un método innovador y con grandes ventajas para el manejo de estas fístulas. Presentación del caso. Hombre de 72 años diagnosticado con adenocarcinoma gástrico de cuerpo y fondo a quien se le realizó una gastrectomía total con linfadenectomía D2 y una anastomosis en Y de Roux con intención curativa en un hospital de cuarto nivel en Popayán, Colombia. Sin embargo, en el posoperatorio presentó síndrome de respuesta inflamatoria sistémica y abdomen agudo producto de fístula esófago-yeyunal. Se realizó manejo inicial con laparotomía, dos lavados de cavidad peritoneal y drenaje abdominal. Posteriormente, el paciente desarrolló abdomen congelado, por lo que no fue posible acceder a la anastomosis esófago-yeyunal. Se intentó cierre de fístula mediante la inserción de prótesis metálica autoexpandible, pero el procedimiento no fue exitoso. Se inició terapia de rescate mediante sistema de cierre asistido por vacío (VAC) por vía endoscópica. Luego de 5 recambios del sistema VAC, se logró el drenaje completo de la colección intraabdominal encontrada, el cierre completo de la cavidad peritoneal y el cierre de la fuga esófago-yeyunal, con una pequeña formación diverticular residual. La condición del paciente mejoró progresivamente, con reinicio de la vía oral a los 20 días del inicio de la terapia VAC. Además, no se reportaron nuevas complicaciones abdominales en el periodo de seguimiento (17 meses). Conclusión. La terapia endoscópica de VAC es una nueva alternativa segura y efectiva para el tratamiento de fístulas postquirúrgicas complejas producto de anastomosis esófago-yeyunales.

Vigilancia epidemiológica de brotes de enfermedades trasmitidas por alimentos en la provincia de Santiago de Cuba / Epidemiologic surveillance of diseases outbreaks transmitted by foods in Santiago de Cuba province

Introducción: Las enfermedades trasmitidas por alimentos se producen por la ingestión de alimentos y/o bebidas contaminados. Objetivo: Identificar los agentes causales que influyen en la aparición de estas enfermedades. Métodos: Se realizó un estudio observacional, descriptivo y transversal del total de brotes de enfermedades trasmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019. Las variables analizadas fueron: número de brotes, muestras de alimentos y muestras de heces fecales para coprocultivo, entre otras. Resultados: En todos los brotes se aisló un solo tipo de agente bacteriano, con predominio de las bacterias gramnegativas, donde la Salmonella fue el microorganismo más identificado. Los principales grupos de alimentos relacionados con la aparición de dichos brotes resultaron ser la carne y sus derivados, así como la ensalada fría. Conclusiones: La vigilancia epidemiológica de brotes de enfermedades transmitidas por alimentos, permitió identificar el verdadero agente causal en los brotes de ETA, al demostrarse identidad entre los aislamientos bacterianos obtenidos de muestras de alimentos y heces fecales.

Introduction: Diseases transmitted by foods take place due to the ingestion of foods and/or contaminated drinks. Objective: To identify the causal agents that influence in the emergence of these diseases. Methods: An observational, descriptive and cross-sectional study of all the diseases outbreaks transmitted by foods was carried out in Santiago de Cuba, from January, 2018 to December, 2019. The analyzed variables were: number of outbreaks, samples of foods and samples of stools for coproculture, among others. Results: In all the outbreaks a single type of bacterial agent was isolated, with prevalence of the gram-negative bacterias, where Salmonella was the most identified microorganism. The main groups of foods related to the emergence of these outbreaks were meat and its derived products, as well as cold salad. Conclusions: The epidemiologic surveillance of diseases outbreaks transmitted by foods, allowed to identify the true causal agent in the FTD outbreaks, when the identity between the bacterial isolations obtained from samples of foods and stools was demonstrated.

Process-Outcome Relationships and Solution-Based Goal-Setting Interventions With Grandparent Caregivers.

The present study examines the impact of change processes on outcomes in a solution-based thinking and goal-setting intervention for grandparents raising their grandchildren. We found that across the 6 program sessions there was stability and/or increases in the salience of hypothesized change processes, i.e., hopefulness about the future, solution-based thinking, positive thoughts about one's grandchild, multiple indicators of decisional personal goal-setting regarding one's own well-being and grandchild relationship quality. Indicators of change processes were for the most part, related to both post-program outcomes as well as to pre-post program outcome difference scores. Regression analyses suggested that change processes in many cases partially mediated pre-post primary program outcome scores. These data suggest that how grandmother caregivers think about themselves and their grandchildren and their approach to setting personal goals are key change processes explaining the impact of a solution-based, goal-setting intervention on them.

Effect and Tolerability of a Nutritional Supplement Based on a Synergistic Combination of ß-Glucans and Selenium- and Zinc-Enriched Saccharomyces cerevisiae (ABB C1®) in Volunteers Receiving the Influenza or the COVID-19 Vaccine: A Randomized, Double-Blind, Placebo-Controlled Study.

A single-center, randomized, double-blind, placebo-controlled study was conducted in 72 volunteers who received a synergistic combination of yeast-based ingredients with a unique ß-1,3/1,6-glucan complex and a consortium of heat-treated probiotic Saccharomyces cerevisiae rich in selenium and zinc (ABB C1®) or placebo on the next day after getting vaccinated against influenza (Chiromas®) (n = 34) or the COVID-19 (Comirnaty®) (n = 38). The duration of treatment was 30 and 35 days for the influenza and COVID-19 vaccine groups, respectively. Mean levels of CD4+T cells increased from 910.7 at baseline to 1000.2 cells/µL after the second dose of the COVID-19 vaccine in the ABB C1® group, whereas there was a decrease from 1055.1 to 929.8 cells/µL in the placebo group. Changes of CD3+T and CD8+T lymphocytes showed a similar trend. In the COVID-19 cohort, the increases in both IgG and IgM were higher in the ABB C1® supplement than in the placebo group. Serum levels of selenium and zinc showed a higher increase in subjects treated with the active product than in those receiving placebo. No serious adverse events related to ABB C1® or tolerance issues were reported. The study findings validate the capacity of the ABB C1® product to stimulate trained immunity.

Caracterización clinicoepidemiológica de pacientes sospechosos y positivos a la COVID-19 en un centro de aislamiento de Santiago de Cuba / Clinical epidemiological characterization of suspicious and positive patients to the COVID-19 in an isolation center from Santiago de Cuba

Introducción: La ciencia cubana ha brindado aportes significativos para el enfrentamiento a la COVID-19, lo que ha facilitado, mediante diversas investigaciones, la predicción, el diseño de modos de enfrentamiento, así como el perfeccionamiento de protocolos terapéuticos y de los modelos de actuación. Objetivo: Caracterizar a pacientes sospechosos y positivos a la COVID-19 ingresados en un centro de aislamiento de Santiago de Cuba. Métodos: Se efectuó un estudio observacional, descriptivo y transversal de los 731 pacientes sospechosos y positivos a la COVID-19, ingresados en el hospital de aislamiento de la Facultad de Medicina No. 2 de Santiago de Cuba, desde enero hasta marzo del 2021, con vistas a caracterizarles según algunas variables clínicas y epidemiológicas seleccionadas, a saber: edad, sexo, antecedentes patológicos personales y síntomas al momento del diagnóstico. Resultados: Del total de pacientes predominaron el sexo masculino (50,8 %) y los grupos etarios de 21-30 y de 51 60 años (21,6 y 20,7 %, respectivamente). En relación con el número de confirmados primaron las féminas (29,2 %) y las áreas de salud con más afectados resultaron ser los policlínicos 28 de Septiembre (22,5 %), 30 de Noviembre (16,8 %) y Mario Muñoz Monroy (14,6 %); asimismo, sobresalieron la hipertensión arterial, el asma bronquial y otras alergias como antecedentes patológicos personales, además de la tos, la fiebre y el malestar general como manifestaciones clínicas. Cabe destacar que 45,6 % de los pacientes con prueba positiva estaban asintomáticos al momento del diagnóstico. Conclusiones: La COVID- 19 constituye un problema prioritario de salud pública y el enfrentamiento a esta terrible pandemia no solo ha traído consigo aplazar metas y transformar objetivos de vida en todos los sectores y naciones, sino también ha implicado redefinir constantemente estrategias y modos de hacer en la búsqueda de un mejor control de la enfermedad.

Introduction: Cuban science has offered significant contributions for the confrontation to the COVID-19, what has facilitated, by means of diverse investigations, the prediction, design of confrontation ways, as well as the improvement of therapeutic protocols and performance models. Objective: To characterize suspicious and positive patients to the COVID-19 admitted to an isolation center from Santiago de Cuba. Methods: An observational, descriptive and cross-sectional study of the 731 suspicious and positive patients to the COVID-19 was carried out. They were admitted to the Medicine Faculty No. 2 isolation hospital from Santiago de Cuba, from January to March, 2021, aimed at characterizing them according to some selected clinical and epidemiologic variables, that is: age, sex, personal pathological history and symptoms at the moment of the diagnosis. Results: Of the total of patients there was a prevalence of the male sex (50.8 %) and the 21-30 and 51-60 age groups (21.6 and 20.7 %, respectively). In connection with the number of confirmed cases there was a prevalence of females (29.2 %) and the health areas with more affected patients were 28 de Septiembre (22.5 %), 30 de Noviembre (16.8 %) and Mario Muñoz Monroy polyclinics (14.6 %); also, hypertension, bronchial asthma and other allergies are notable as personal pathological history, besides cough, fever and diffuse discomfort as clinical signs. It is remarkable that 45.6 % of the patients with positive test were asymptomatic at the moment of the diagnosis. Conclusions: The COVID-19 constitute a high-priority problem of public health and the confrontation to this terrible pandemic not only has brought in itself to postpone goals and transform objectives of life in all sectors and nations, but it has also implied to constantly redefine strategies and ways of doing in the search of a better control of the disease.

Alterations in biochemical markers in adenovirus infection.

BACKGROUND: Analyze possible relationships between HAdV and markers for inflammation, specifically the C-reactive protein (CRP) and procalcitonin (PCT) tests, along with other haematological markers. METHODS: Retrospective study of 487 children presenting with fever and/or acute respiratory symptoms in the Paediatric Emergency Department. Analyses included viral presence/absence (both HAdV and other respiratory viruses) in respiratory exudates, CRP and PCT alterations in plasma, and haematological markers in whole blood. RESULTS: Viral load was >500 copies/103 cells of HAdV in 127 cases (26.1%), of which 66 (52%, P<0.0001) had alterations in PCT, and 112 (88.1%, P<0.0001) in CRP. Haematological markers were similar either HAdV was present or not, although many HAdV positive patients demonstrated leukocytosis (66%). Bacterial cultures from 141 samples showed altered PCT in 27 (60%) with HAdV infection, in 3 (18.7%) with bacterial infection, and 13 (26.5%) without either viral or bacterial infection (P<0.05). CRP was altered in 88.9% of HAdV infected children and in 87% infected with bacteria, although the percentage was greater than in cases where other respiratory viruses were present (61.3% P<0.05). CONCLUSIONS: Results demonstrate a clear relationship between HAdV infection and alterations in PCT and CRP which should be taken into account in paediatric patient management.

The Utility of Solution-Oriented Strategies to Support Grandparents Raising Grandchildren.

Objectives: The purpose of this article is to evaluate the effectiveness of a psychosocial intervention program to improve the health and social psychological outcomes for grandparents raising grandchildren using the theory of Selection, Optimization, and Compensation (Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). Cambridge University Press. doi:10.1017/CBO9780511665684.003). Methods: Fifty-two grandparents were randomly assigned either to a 6-session solution-oriented goal-setting program or to a waiting list control condition who subsequently received the intervention. Results: Grandparents in the intervention group, in comparison to the waiting list control group, reduced their level of depression, improved their parental efficacy, overall psychosocial adjustment, and increased their ability to choose effective goals. For the most part, findings were replicated in the waiting list control analyses. Discussion: While these findings are consistent with previous studies using psychosocial interventions with parents and grandparent caregivers, they also provide support for strength-based proactive behavioral approaches to improve the quality of life of grandparent caregivers.

A Multiplex TaqMan qPCR Assay for Detection and Quantification of Clade 1 and Clade 2 Isolates of Pseudoperonospora cubensis and Pseudoperonospora humuli.

The ability to detect and quantify aerially dispersed plant pathogens is essential for developing effective disease control measures and epidemiological models that optimize the timing for control. There is an acute need for managing the downy mildew pathogens infecting cucurbits and hop incited by members of the genus Pseudoperonospora (Pseudoperonospora cubensis clade 1 and 2 isolates and Pseudoperonospora humuli, respectively). A highly specific multiplex TaqMan quantitative polymerase chain reaction (PCR) assay targeting unique sequences in the pathogens' mitochondrial genomes was developed that enables detection of all three taxa in a single multiplexed amplification. An internal control included in the reaction evaluated whether results were influenced by PCR inhibitors that can make it through the DNA extraction process. Reliable quantification of inoculum as low as three sporangia in a sample was observed. The multiplexed assay was tested with DNA extracted from purified sporangia, infected plant tissue, and environmental samples collected on impaction spore traps samplers. The ability to accurately detect and simultaneously quantify all three pathogens in a single multiplexed amplification should improve management options for controlling the diseases they cause.

Testing a Proactive Model of Successful Aging Among Older Adults in Costa Rica and Spain.

The purpose of this study is to examine successful aging among Spanish-speaking older adults in Costa Rica and in Spain using the proactive framework proposed by Kahana et al. (2014). More specifically, we hypothesized that older adults' life satisfaction would be positively associated with the frequency and perceived level of social support, spirituality/having purpose in life, and the use of proactive physical, cognitive, and social self-care behaviors. Our results confirmed these hypotheses, not only for the overall group of participants, but also separately for older adults in Costa Rica and in Spain. The present study contributes to the literature of successful aging among older adults, by examining the protective factors associated with life satisfaction among Spanish speaking older adults in Costa Rica and in Spain. It identifies specific protective factors (spirituality/purpose in life, social support, and self-care) associated with the values and preferences held by participants in the study.

Caracterización de agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos / Characterization of bacterial agents isolated in diseases outbreaks transmitted by foods

Introducción: Las enfermedades transmitidas por alimentos se producen por ingestión de un alimento, incluido el agua, que puede estar contaminado por diversos agentes. Objetivo: Caracterizar los agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 100,0 % de los brotes de enfermedades transmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019, para lo cual se seleccionaron muestras de alimentos y heces fecales. La caracterización de las bacterias aisladas se basó en los resultados del crecimiento y otras pruebas bioquímicas-metabólicas. Se utilizaron resultados del aislamiento y confirmación de los agentes identificados en cada uno de los brotes a partir de las muestras antes citadas. Entre las variables analizadas figuraron: número de brotes, muestras de alimentos, de heces fecales y resultados de pruebas bioquímicas y metabólicas. Resultados: Se obtuvo un aislamiento de agentes bacterianos en 100,0 % de las muestras de alimentos. Hubo una mayor frecuencia de bacterias Gram negativas (82,0 %) y la menor correspondió a microorganismos Gram positivos (18,0 %). La Salmonella D fue el microorganismo más frecuente. Conclusiones: Este resultado representa un instrumento para el diagnóstico etiológico de los brotes de enfermedades transmitidas por alimentos en Santiago de Cuba.

Introduction: Diseases transmitted by foods are produced due to ingestion of a food, including water that can be contaminated by diverse agents. Objective: To characterize the bacterial agents isolated in diseases outbreaks transmitted by foods. Methods: An observational, descriptive and cross-sectional study of 100.0 % of the diseases outbreaks transmitted by foods in Santiago de Cuba, from January, 2018 to December, 2019 was carried out, for which samples of foods and stools were selected. The characterization of the isolated bacterias was based on the results of growth and other biochemical-metabolic tests. Results of the isolation and confirmation of agents identified in each one of the outbreaks from the samples mentioned above were used. Among the analyzed variables we can mention: number of outbreaks, samples of foods, samples of stools and results of biochemical and metabolic tests. Results: An isolation of bacterial agents was obtained in 100.0 % of foods samples. There was a higher frequency of Gram negative bacterias (82.0 %) and the lower corresponded to Gram positive microorganisms (18.0 %). Salmonella D was the most frequent microorganism. Conclusions: This result represents an instrument for the etiological diagnosis of diseases outbreaks transmitted by foods in Santiago de Cuba.

Factores determinantes relacionados con la incidencia de la tuberculosis en un municipio de Santiago de cuba / Determining factors related to the incidence of the tuberculosis in a municipality of Santiago de Cuba

Introducción: La tuberculosis es una enfermedad infectocontagiosa que afecta a un gran número de personas a escala mundial. Objetivo: Describir las características de dicha enfermedad en el municipio de Mella, atendiendo a algunos determinantes sociodemográficos, socioculturales, de la conducta social, biológicos, ambientales y de los servicios de salud e identificar en la comunidad los factores de riesgo presentes. Métodos: Se realizó un estudio con diseños combinados, de tipo ecológico y de corte transversal. El universo quedó constituido por los 7 casos notificados con tuberculosis pulmonar en el municipio de Mella, provincia de Santiago de Cuba, desde el 2016 hasta el 2018. Resultados: Entre los grupos de riesgo más afectados figuraron: adultos mayores, alcohólicos, diabéticos y desnutridos; con mayor incidencia en el sexo masculino. Entre otros hallazgos se detectaron las posibles asociaciones entre la incidencia de la tuberculosis y los factores de riesgo. Conclusiones: Las tasas de incidencias se asociaron de forma directa con la densidad poblacional, el hacinamiento, la poca ventilación y la insuficiente iluminación.

Introduction: Tuberculosis is an infectocontagious disease that affects a great number of people worldwide. Objective: To describe the characteristics of this disease in the municipality of Mella, according to some social-demographic, social -cultural, social-behavioural, biological, environmental determinants as well as of health services and to identify the risk factors present in the community. Methods: An ecological, cross sectional study with combined designs was carried out. The universe was constituted by the 7 cases notified with lung tuberculosis in the municipality of Mella, Santiago de Cuba, from 2016 to 2018. Results: Among the most affected risk groups we can mention: elderly, alcoholic, diabetics and undernourished adults; with more incidence in male sex. Among other findings, the possible associations between the incidence of tuberculosis and the risk factors were detected. Conclusions: The rates of incidences were associated in a direct way to the populational density, overcrowding, little ventilation and scarce illumination.