Ciber violencia contra la pareja en universitarios de España y Latinoamérica / Cyber violence against the couple in university students in Spain and Latin America

El objetivo de la investigación fue estudiar la presencia de ciber violencia contra la pareja en estudiantes universitarios de España y Latinoamérica, así como como analizar su relación con los mitos románticos y el sexismo ambivalente. La investigación tiene un diseño transversal. La muestra estaba formada por 2.798 estudiantes de siete países hispanohablantes: España, El Salvador, Nicaragua, Colombia, Chile, Argentina y México. Los resultados muestran pocas diferencias de medias entre hombres y mujeres; sin embargo, las diferencias entre países son considerables, sobre todo en la perpetración de agresiones directas y control. Las distintas formas de ciber violencia contra la pareja tienden a correlacionar, en una dirección positiva, con las actitudes sexistas y las creencias distorsionadas sobre el amor romántico. En conclusión, los programas de prevención deberían tener en cuenta las nuevas manifestaciones de la violencia que están apareciendo en los espacios virtuales.(AU)

The objective of the research was to study the presence of cyber violenceagainst partners in university students in Spain and Latin America, as well as toanalyze its relationship with romantic myths and ambivalent sexism. The researchhas a cross-sectional design. The sample was made up of 2,798 students fromseven Spanish-speaking countries: Spain, El Salvador, Nicaragua, Colombia, Chile,Argentina, and Mexico. The results show few differences in means between menand women; However, the differences between countries are considerable,especially in the perpetration of direct attacks and control. The different forms ofcyber violence against a partner tend to correlate, in a positive direction, with sexistattitudes and distorted beliefs about romantic love. In conclusion, preventionprograms should take into account the new manifestations of violence that areappearing in virtual spaces.(AU)

Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation.

BACKGROUND: Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings. METHOD: We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare. RESULTS: Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases. DISCUSSION: Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.

Impact of an International Training on Interventionists' Expertise in Cleft Palate Speech: Results From Oaxaca, Mexico.

PURPOSE: International cleft lip and palate surgical charities recognize that speech therapy is essential for successful care of individuals after palate repair. The challenge is how to ensure that cleft speech interventionists (i.e., speech-language pathologists and other speech therapy providers) provide quality care. This exploratory study investigated effects of a two-stage cleft training in Oaxaca, Mexico, aimed at preparing speech interventionists to provide research-based services to individuals born with cleft palate. Changes in the interventionists' content knowledge and clinical skills were examined. METHOD: Twenty-three cleft speech interventionists from Mexico, Guatemala, and Nicaragua participated in a hybrid two-stage training, completing an online Spanish cleft speech course and a 5-day in-person training in Oaxaca. In-person training included a didactic component and supervised clinical practice with 14 individuals with repaired cleft palates. Testing of interventionists' content knowledge and clinical skills via questionnaires occurred before the online course (Test 1), immediately before in-person training (Test 2), and immediately after in-person training (Test 3). Qualitative data on experience/practice were also collected. RESULTS: Significant increases in interventionists' overall content knowledge and clinical skills were found posttraining. Knowledge and clinical skills increased significantly between Tests 1 and 2. Clinical skills, but not knowledge, showed further significant increases between Tests 2 and 3. Posttraining, interventionists demonstrated greater expertise in research-based treatment, and fewer reported they would use nonspeech oral motor exercises (NSOME). CONCLUSIONS: Findings provide preliminary support for such two-stage international trainings in preparing local speech interventionists to deliver high-quality speech services to individuals born with cleft palate. While content knowledge appears to be acquired primarily from the online course, the two-stage training incorporating in-person supervised practice working with individuals born with cleft palate may best enhance continued clinical skill development, including replacement of NSOME with evidence-based speech treatment. Such trainings contribute to building capacity for sustainable quality services for this population in underresourced regions.

Persistence of dengue serotype 2 viral RNA in blood cells of a returned traveler with dengue fever.

Dengue virus (DENV) is one of the most significant vector-borne pathogens worldwide. In this report, we describe clinical features and laboratory detection of dengue in a 45-year-old traveler to Nicaragua on return home to the United States in 2019. Clinical presentation was mild, with rash, headache, and fatigue, with only low-grade transient fever. Infection dynamics were documented by serology and PCR of serially collected body fluids. DENV serotype 2 was detected in whole blood 1 day after symptoms emerged, with viral RNA isolated to the red cell fraction, and remained detectable through day 89. DENV-2 RNA was detected in serum only on day 4, and IgM was undetectable on day 4 but evident by day 13. Viral RNA was also detected in urine. This report of DENV-2 RNA persistence in blood cells but only transient appearance in serum, supports the potential diagnostic value of whole blood over serum for PCR and opportunity of an expanded testing window. Informed testing approaches can improve diagnostic accuracy and inform strategies that preserve individual and public health.

Longitudinal analysis of post-acute chikungunya-associated arthralgia in children and adults: A prospective cohort study in Managua, Nicaragua (2014-2018).

Chikungunya can result in debilitating arthralgia, often presenting as acute, self-limited pain, but occasionally manifesting chronically. Little is known about differences in chikungunya-associated arthralgia comparing children to adults over time. To characterize long-term chikungunya-associated arthralgia, we recruited 770 patients (105 0-4 years old [y/o], 200 5-9 y/o, 307 10-15 y/o, and 158 16+ y/o) with symptomatic chikungunya virus infections in Managua, Nicaragua, during two consecutive chikungunya epidemics (2014-2015). Participants were assessed at ~15 days and 1, 3, 6, 12, and 18 months post-fever onset. Following clinical guidelines, we defined participants by their last reported instance of arthralgia as acute (≤10 days post-fever onset), interim (>10 and <90 days), or chronic (≥90 days) cases. We observed a high prevalence of arthralgia (80-95%) across all ages over the study period. Overall, the odds of acute arthralgia increased in an age-dependent manner, with the lowest odds of arthralgia in the 0-4 y/o group (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.14-0.51) and the highest odds of arthralgia in the 16+ y/o participants (OR: 4.91, 95% CI: 1.42-30.95) relative to 10-15 y/o participants. Females had higher odds of acute arthralgia than males (OR: 1.63, 95% CI: 1.01-2.65) across all ages. We found that 23-36% of pediatric and 53% of adult participants reported an instance of post-acute arthralgia. Children exhibited the highest prevalence of post-acute polyarthralgia in their legs, followed by the hands and torso - a pattern not seen among adult participants. Further, we observed pediatric chikungunya presenting in two distinct phases: the acute phase and the subsequent interim/chronic phases. Thus, differences in the presentation of arthralgia were observed across age, sex, and disease phase in this longitudinal chikungunya cohort. Our results elucidate the long-term burden of chikungunya-associated arthralgia among pediatric and adult populations.

Impact of heat and a rest-shade-hydration intervention program on productivity of piece-paid industrial agricultural workers at risk of chronic kidney disease of nontraditional origin.

OBJECTIVES: Assess the impact of environmental heat and a rest-shade-hydration (RSH) intervention against heat stress on productivity of piece-paid Mesoamerican sugarcane cutters. These workers are at a high risk of chronic kidney disease of non-traditional origin (CKDnt), from the severe heat stress they experience due to heavy work under hot conditions. RSH interventions in these populations improve kidney health outcomes, but their impact on productivity has yet to be examined. METHODS: We accessed routine productivity data from seed (SC, N = 749) and burned (BCC, N = 535) sugarcane cutters observed over five harvest seasons with increasing RSH intervention at a large Nicaraguan sugarcane mill. Hourly field-site wet-bulb globe temperature (WBGT) was recorded by mill staff and summarized as a daily mean. Mixed linear regression was used to model daily productivity, adjusting for age (18-29, 30-44, and >45 years), sex, WBGT (<28, 28-29, 29-30, 30-31, and >31 °C) on the same and preceding day, harvest season (2017-18 to 2021-22), month, and acclimatization status (<1, 1-2, and >2 weeks). RESULTS: There was an inverse dose-response relationship between SC productivity and WBGT on the same and preceding days, decreasing by approximately 3%/°C WBGT. Productivity increased during the study period, i.e. coinciding with RSH scale-up, by approximately 19% in SC and 9% in BCC. CONCLUSION: Agricultural worker productivity was expected lower on hotter days, strengthening the interest in all stakeholders to mitigate increasing global temperatures and their impact. Despite decreasing the total time allocated for work each day, an RSH intervention appears to result in increased productivity and no apparent loss in productivity.

Analysis of recent land management initiatives in Nicaragua from the perspective of the "ecosystem approach".

In the world there are approximately 608 million farms, of which 84% are small farms and produce 35% of the food of the world population. Training programs have been promoted by different organizations to achieve a more sustainable and efficient agricultural practice. Within this context, this article has classified a set of smallholders located in central Nicaragua with regard to how they apply Land Use Management Initiatives (LUMI). The aim is to outline their weaknesses and strengths and thus identify key elements that can contribute to improving soil resource management. We focus on the LUMI carried out in Nicaragua in the municipalities of El Tuma-La Dalia, El Cuá and Waslala between 1992 and 2022. To conduct this study, eight LUMI were identified and analysed, and 25 indicators linked to the Malawi Principles were extracted and selected for the design of a survey in order to collect land use management information from 455 farms in the study area. Simple random sampling was used to select the farms. Subsequently, the collected data were analysed using descriptive statistics and Multivariate Analysis techniques. The results reveal that in the study area, the LUMI incorporate between one and five Malawi Principles. The multivariate analysis techniques employed identified three clusters of farms, with either Active, Moderate or Improvable ecosystem management. The study area as a whole displays strengths in social participation, local capacity building, soil and environmental conservation practices, with the farm as the main source of income. Weaknesses lie in the fact that indicators referring to household income and productivity are less frequent. In terms of farm management, the results revealed that combined male and female management was similar in percentage to male-only management. The results highlight the need to continue with the implementation of environmental goals linked to the design of initiatives that promote productivity, income and gender equity in farm management in an integrated manner. At the same time, existing local capacities for sustainable soil and ecosystem management should be brought together and strengthened.

Transmission Patterns of Norovirus From Infected Children to Household Members in León, Nicaragua.

Norovirus is a common and highly transmissible gastrointestinal pathogen. Among 34 Nicaraguan households with a norovirus-infected child, 48% experienced norovirus transmission within 1 week, infecting 18% of household members; GII norovirus was more commonly transmitted than GI. Pediatric norovirus vaccines could prevent both index cases and transmission to close contacts.

Moral reasoning about gang violence in context: A comparative study with children and adolescents exposed to maras in Honduras and not exposed in Nicaragua.

This study examined how youth morally deliberate about conditions of gang violence shaping their communities. Participants (N = 80; 10-11 and 14-15 years; 50% female) exposed to gangs (maras) in Honduras and not exposed to maras in Nicaragua evaluated hypothetical situations of physical harm in contexts of chronic gang violence. Results indicated that mara-exposed youth were more likely to endorse harming a rival gang member in some contexts, but not others. Moreover, in some contexts, males were more likely to endorse harming others as necessary. Few age differences emerged, suggesting comparability among children and adolescents. Discussion focuses on how children and adolescents coordinate different moral and social concepts and concerns pertaining to acts of physical harm in situations involving gangs.

Enduring association between irritable bowel syndrome and war trauma during the Nicaragua civil war period: A population-based study.

BACKGROUND: Psychosocial and physical trauma are known risk factors for irritable bowel syndrome (IBS), including in war veterans, whereas war exposure in civilians is unclear. Nicaragua experienced two wars, 1970-1990: The Sandinistas Revolution (1970s) and The Contra War (1980s). Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system (11000 households). AIM: To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua. METHODS: We conducted a nested population-based, cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria. 1617 adults were randomly selected. The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua. War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects. Multiple exposures were defined by ≥ 3 measures. RESULTS: The prevalence of IBS was 15.2% [Female (F) 17.1%, Male (M) 12.0%], war exposure 19.3% (F 9.3%, M 36.7%), and post-traumatic stress disorder (PTSD) 5.6% (F 6.4%, M 4.3%). Significant associations with IBS in the civilian population were observed (adjusted by gender, age, socioeconomic status, education): physical and psychological abuse [adjusted odds ratio (aOR): 2.25; 95% confidence interval: 1.1-4.5], witnessed execution (aOR: 2.4; 1.1-5.2), family member death (aOR: 2.2; 1.2-4.2), and multiple exposures (aOR: 2.7; 1.4-5.1). PTSD was independently associated with IBS (aOR: 2.6; 1.2-5.7). CONCLUSION: An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS. Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.

Developing the agroecological niche in Nicaragua: The roles of knowledge flows and intermediaries.

Supporting transitions to sustainable, resilient agri-food systems is important to ensure stable food supply in the face of growing climate extremes. Agroecology, or diversified farming systems based on ecological principles, can contribute to such systems. Based on a qualitative case study of Nicaragua, a forerunner in agroecology, this paper unpacks an ongoing transition to agroecology, focusing on how the transition has been shaped by knowledge flows and intermediary actors. Using a niche development framework based on knowledge processes, we analyze the growth of the agroecological niche in Nicaragua over three phases of niche development. The findings show how knowledge processes' emphases have shifted over time, as have functions enacted by intermediaries. Dedicated, diversified intermediaries have been key in creating momentum for agroecology, as have individual actors moving between niche and regime. Agency in niche development has come from both niche and regime actors. Finally, we find that Nicaragua's transition to agroecology has been ambiguous: While the niche has succeeded in changing the mainstream selection environment to its favor in some arenas, transition dynamics lag in others. Drawing lessons from this ambiguity, we suggest entry points for broader systems change, such as market stimulation, value chain development, phase-out policies, and supportive policy in related arenas. We also point out possible actions for niche actors such as integration of financial and commercial actors into niches and creation of dedicated market-focused intermediaries. Our results provide evidence of an ongoing transition and action points for supporting niche development in (sustainable agri-food) transitions around the globe.

Kidney disease characteristics, prevalence, and risk factors in León, Nicaragua: a population-based study.

BACKGROUND: CKD of unknown etiology (CKDu) disproportionately affects young people in Central America who lack traditional CKD risk factors (diabetes and hypertension) and has instead been variably linked to heat stress, occupational and environmental exposures, nephrotoxic medications, and/or genetic susceptibility. This study aimed to estimate the prevalence of CKD and identify risk factors for traditional CKD and CKDu in Nicaragua. METHODS: Surveys and assessment for CKD markers in urine and serum were performed in 15-59 year olds in households of the León municipality of Nicaragua. The survey included questions on demographics, health behaviors, occupation, and medical history. Participants with CKD were subdivided into traditional CKD and suspected CKDu based on history of diabetes, hypertension, or other specified conditions. A multinomial logistic regression model was used to identify factors associated with traditional CKD and suspected CKDu, compared to the non-CKD reference group. RESULTS: In 1795 study participants, CKD prevalence was 8.6%. Prevalence in males was twofold higher than females (12% vs 6%). Of those with CKD, 35% had suspected CKDu. Both traditional CKD and CKDu were associated with male sex and increasing age. Traditional CKD was associated with a family history of CKD, history of urinary tract infections, and lower socioeconomic status, while CKDu was associated with drinking well water and a lower body mass index. CONCLUSIONS: Both traditional CKD and CKDu are significant burdens in this region. Our study supports previous hypotheses of CKDu etiology and emphasizes the importance of CKD screening.

Phylodynamics of dengue virus 2 in Nicaragua leading up to the 2019 epidemic reveals a role for lineage turnover.

BACKGROUND: Dengue is a mosquito-borne viral disease posing a significant threat to public health. Dengue virus (DENV) evolution is often characterized by lineage turnover, which, along with ecological and immunological factors, has been linked to changes in dengue phenotype affecting epidemic dynamics. Utilizing epidemiologic and virologic data from long-term population-based studies (the Nicaraguan Pediatric Dengue Cohort Study and Nicaraguan Dengue Hospital-based Study), we describe a lineage turnover of DENV serotype 2 (DENV-2) prior to a large dengue epidemic in 2019. Prior to this epidemic, Nicaragua had experienced relatively low levels of DENV transmission from 2014 to 2019, a period dominated by chikungunya in 2014/15 and Zika in 2016. RESULTS: Our phylogenetic analyses confirmed that all Nicaraguan DENV-2 isolates from 2018 to 2019 formed their own clade within the Nicaraguan lineage of the Asian/American genotype. The emergence of the new DENV-2 lineage reflects a replacement of the formerly dominant clade presiding from 2005 to 2009, a lineage turnover marked by several shared derived amino acid substitutions throughout the genome. To elucidate evolutionary drivers of lineage turnover, we performed selection pressure analysis and reconstructed the demographic history of DENV-2. We found evidence of adaptive evolution by natural selection at the codon level as well as in branch formation. CONCLUSIONS: The timing of its emergence, along with a statistical signal of adaptive evolution and distinctive amino acid substitutions, the latest in the NS5 gene, suggest that this lineage may have increased fitness relative to the prior dominant DENV-2 strains. This may have contributed to the intensity of the 2019 DENV-2 epidemic, in addition to previously identified immunological factors associated with pre-existing Zika virus immunity.

Household environment and animal fecal contamination are critical modifiers of the gut microbiome and resistome in young children from rural Nicaragua.

BACKGROUND: Early life plays a vital role in the development of the gut microbiome and subsequent health. While many factors that shape the gut microbiome have been described, including delivery mode, breastfeeding, and antibiotic use, the role of household environments is still unclear. Furthermore, the development of the gut antimicrobial resistome and its role in health and disease is not well characterized, particularly in settings with water insecurity and less sanitation infrastructure. RESULTS: This study investigated the gut microbiome and resistome of infants and young children (ages 4 days-6 years) in rural Nicaragua using Oxford Nanopore Technology's MinION long-read sequencing. Differences in gut microbiome diversity and antibiotic resistance gene (ARG) abundance were examined for associations with host factors (age, sex, height for age z-score, weight for height z-score, delivery mode, breastfeeding habits) and household environmental factors (animals inside the home, coliforms in drinking water, enteric pathogens in household floors, fecal microbial source tracking markers in household floors). We identified anticipated associations of higher gut microbiome diversity with participant age and vaginal delivery. However, novel to this study were the significant, positive associations between ruminant and dog fecal contamination of household floors and gut microbiome diversity. We also identified greater abundance of potential pathogens in the gut microbiomes of participants with higher fecal contamination on their household floors. Path analysis revealed that water quality and household floor contamination independently and significantly influenced gut microbiome diversity when controlling for age. These gut microbiome contained diverse resistome, dominated by multidrug, tetracycline, macrolide/lincosamide/streptogramin, and beta-lactam resistance. We found that the abundance of ARGs in the gut decreased with age. The bacterial hosts of ARGs were mainly from the family Enterobacteriaceae, particularly Escherichia coli. CONCLUSIONS: This study identified the role of household environmental contamination in the developing gut microbiome and resistome of young children and infants with a One Health perspective. We found significant relationships between host age, gut microbiome diversity, and the resistome. Understanding the impact of the household environment on the development of the resistome and microbiome in early life is essential to optimize the relationship between environmental exposure and human health. Video Abstract.

Migratory destinations and spatial structuring of humpback whales (Megaptera novaeangliae) wintering off Nicaragua.

Understanding the migratory patterns of large whales is of conservation importance, especially in identifying threats to specific populations. Migration ecology, including migratory destinations, movements and site fidelity for humpback whales (Megaptera novaeangliae) remain poorly studied in parts of the range of the Central America population, considered endangered under the United States Endangered Species Act. This study aimed to investigate the migratory destinations of humpback whales sighted at two study sites in Nicaragua, which are part of the Central America population. A ten-year photographic database of humpback whales observed off Nicaragua was combined with citizen science contributions and sightings from dedicated research programs. The resulting image collection was compared with available historical photo identifications and databases using an automated image recognition algorithm. This approach yielded 36 years of photographic identification totaling 431 recaptures in Nicaragua (2006-2008 and 2016-2021) and 2539 recaptures (1986-2020) in both feeding and breeding grounds of 176 unique individuals sighted in Nicaragua. Our results showed that photo-identified whales were recaptured between October and April in breeding grounds and year-round in feeding grounds between British Columbia and California, with peak recaptures between June and October. Our study provided first-time evidence on fine-scale site affinity of individual humpback whales within Nicaraguan waters and to other breeding and feeding grounds.

Perfil de carga de enfermedad por diabetes 2023: Nicaragua

El propósito fundamental de esta serie de perfiles nacionales de la carga de enfermedad por diabetes y de enfermedad renal crónica debida a diabetes es apoyar a los países de la Región de las Américas en el seguimiento de las estrategias puestas en marcha para enfrentar la diabetes. Esta primera versión de los perfiles, que abarca el período comprendido entre el 2000 y el 2019, muestra la tendencia de la mortalidad, los años de vida perdidos por muerte prematura, los años vividos con discapacidad y los años de vida ajustados por discapacidad de ambas enfermedad. Se han elaborado con los últimos datos disponibles de las estimaciones mundiales de salud de la Organización Mundial de la Salud y tiene como objetivo convertirse en una herramienta útil para llevar a cabo el monitoreo de las estrategias conexas.

Effectiveness of Home Gardening in Improving Food Security and Health in Chacraseca, Nicaragua: A Pilot Study.

We studied the usefulness of home gardening in improving food security and health. One hundred participants were randomized into the control and intervention group of which the intervention group received training in home gardening. Results showed that the percentage of participants with normal body mass index decreased from 24.4% to 20% in the control group whereas it remained unchanged in the intervention group. The number of participants in the very low food security category decreased from 66% (n=33) to 54% (n=27) in the intervention group whereas it increased from 68.8% (n=33) to 70.8% (n=34) in the control group. Results from the present study may be used to guide policymakers in designing or modifying home gardening interventions.