A multiplex real-time PCR assay for identification of Pneumocystis jirovecii, Histoplasma capsulatum, and Cryptococcus neoformans/Cryptococcus gattii in samples from AIDS patients with opportunistic pneumonia.

A molecular diagnostic technique based on real-time PCR was developed for the simultaneous detection of three of the most frequent causative agents of fungal opportunistic pneumonia in AIDS patients: Pneumocystis jirovecii, Histoplasma capsulatum, and Cryptococcus neoformans/Cryptococcus gattii. This technique was tested in cultured strains and in clinical samples from HIV-positive patients. The methodology used involved species-specific molecular beacon probes targeted to the internal transcribed spacer regions of the rDNA. An internal control was also included in each assay. The multiplex real-time PCR assay was tested in 24 clinical strains and 43 clinical samples from AIDS patients with proven fungal infection. The technique developed showed high reproducibility (r(2) of >0.98) and specificity (100%). For H. capsulatum and Cryptococcus spp., the detection limits of the method were 20 and 2 fg of genomic DNA/20 µl reaction mixture, respectively, while for P. jirovecii the detection limit was 2.92 log10 copies/20 µl reaction mixture. The sensitivity in vitro was 100% for clinical strains and 90.7% for clinical samples. The assay was positive for 92.5% of the patients. For one of the patients with proven histoplasmosis, P. jirovecii was also detected in a bronchoalveolar lavage sample. No PCR inhibition was detected. This multiplex real-time PCR technique is fast, sensitive, and specific and may have clinical applications.

Psychotropic drugs and driving: prevalence and types.

BACKGROUND: Some psychotropic medications (e.g., benzodiazepines, sedative antidepressants, etc.) may impair cognitive and psychomotor functions and, therefore, endanger traffic safety (Ravera, Br J Clin Pharmacol, 72(3):505-513, 2011). They affect detection, registration, and information processing, problem solving, and decision-making processes, and they also affect emotional and social aspects. The objective of this research was to clarify three closely related issues that are significant for traffic safety: the prevalence of psychotropic drugs on driving, the most frequently used psychotropic drugs to treat depression, anxiety, insomnia, or any tranquilizers (whether it is a medical prescription or self-medication), and finally, provide a further understanding of the socio-demographic and psycho-social characteristics of drivers related to the psychotropic drugs consumption in Spain. METHODS: A sample of 1,200 Spanish drivers ranging from 18 to 64 years was used, 666 men and 534 women were asked to answer a questionnaire composed by a set of questions structured in different sections. The only selection criteria were to be in possession of any type of driving license for vehicles other than motorcycles and drive frequently. RESULTS: The results showed that 15% of the participants were consuming psychotropic drugs to treat depressive disorders, anxiety disorders, insomnia, or tranquilizers; 13.5% were using drugs to treat one of these disorders; while 1.5% used them for several of these disorders. A 2.5% of drivers were using medicines to treat depression, 2.6% to treat anxiety, and 3.7% to treat insomnia. The 8.3% of those drivers who were not using any drugs to treat these three disorders were occasionally using some type of tranquilizers. Benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) were the most used type of medicines among drivers. Benzodiazepines were the most used medicines to treat anxiety, while SSRIs were the most used to treat depression, 56.5% and 43.5%, respectively. CONCLUSIONS: Measures can be developed to reduce traffic accidents caused by the effects of these drugs; however, this will only be possible once the drivers and the use of these drugs are understood. Health care professionals and patients should be properly informed about the potential effects of some psychotropic medications on driving abilities considering individual and group differences.

Sustainable behavior begins with sustainable attitudes: Data to assess the relationships between demographics, concerns about transport-related pollution, and willingness for action.

This Data in Brief (DiB) article addresses the relationships among individuals' transport habits, perceptions, and attitudes regarding transport-related pollution, as well as their willingness to act for environmental change. There are presented descriptive statistics, basic comparisons, and bivariate correlations among the core variables of the study. Additionally, the attached dataset appends information from a nationwide sample of 1,250 citizens in the Dominican Republic, with sex, age and habitat distribution proportional to the national census. The research database contains the full set of questions and responses to the research questionnaire, which is also attached to the supplementary files along with its codebook, making it possible to conduct further data explorations for research-related, divulgation, and educational purposes. For more information about the root study, it is advisable to read the paper "Who wants to change their transport habits to help reduce air pollution? A nationwide study in the Caribbean", published in Journal of Transport & Health [1].

Public transportation means as seen by citizens: Approaching the case of the Dominican Republic.

and middle-income countries, key constraints such as dense traffic flows, jams, and pollution constitute frequent issues that potentially explain many negative consequences in terms of (e.g.) efficiency, sustainability, and mobility safety. In this regard, recent evidence supports the idea that fostering public transportation is crucial to offering solutions for this difficult panorama. However, transport mode-related choices and shifts have been proven to depend highly on key perceptions and needs of potential users. The aim of this study was to analyze a set of key users' perceptions, usage, and perceived quality of public transportation in the Dominican Republic, as well as to explore the most relevant features for Dominicans from the "desired quality" paradigm. For this research at a national level, data retrieved from a nationwide sample of 1254 inhabitants of the Dominican Republic was used, proportional to the ONE census in terms of sex, age, habitat, and region. Overall, the results show that the general quality of transportation is 6.70 points out of 10. The use of public transportation in the Dominican Republic has a medium-low rating and is very focused on urban buses (41 %) and public cars (27.1 %). Nonetheless, the metro remains the most highly rated means of transport (M = 8.75). Concerning the quality variables analyzed, the highest scores are for accessibility (M = 7.08) and frequency of service (M = 6.99). Further, Dominicans focus on improving comfort, vehicle conditions, and safety. This study constitutes a first approximation to the desired quality of public transportation for Dominican Citizens, which may help policymakers scope user-based needs in public transportation systems and encourage a more frequent (and friendlier) public transport use in the country.

Compliance, practices, and attitudes towards VTIs (Vehicle Technical Inspections) in Spain: What prevents Spanish drivers from checking up their cars?

OBJECTIVE: Mechanical conditions of vehicles may play a determinant role in driving safety, the reason why vehicle periodical technical inspections (VTIs) are mandatory in many countries. However, the high number of drivers sanctioned for not complying with this regulation is surprisingly high, and there is not much evidence on what kind(s) of motives may explain this concerning panorama. This study aimed to identify the aspects that modulate the relationship between complying (or not) with VTI's standards in a nationwide sample of Spanish drivers. The study design also addressed the drivers' awareness regarding different risky behaviors while driving, depending on their sex and their crash record. METHODS: 1,100 Spanish drivers completed a survey on the aforementioned issues. An analysis of variance (ANOVA) with Bonferroni post-hoc adjustment was conducted to assess significant differences (p<0.05) in the study variables. RESULTS: Most of the surveyed drivers (99.18%) reported that they always comply with VTI's requirements. The main reasons to comply were related to compliance with traffic regulation and fear of penalties, while the reasons attributed to its incompliance are, instead, stated as involuntary. CONCLUSION: The findings of this study support the idea that more actions are needed to increase drivers' awareness of the relevance of VTIs for road safety, as well as warning them about the dangers of neglecting vehicle checking beyond merely punishing measures. For this reason and given the greater prevalence of the issue among younger segments of the driving population, it is suggested that more emphasis on the matter could be made during novice driver's training.

Are Latin American cycling commuters "at risk"? A comparative study on cycling patterns, behaviors, and crashes with non-commuter cyclists.

INTRODUCTION: As part of the transformation of urban transportation dynamics, commuter cycling has acquired a high relevance as an alternative mode of transport in different countries, and Latin America seems to be one of the main focus of this worldwide "revolution". However, the high rates of crashes and injuries suffered by commuters have become a relevant issue in the field of road safety, especially in emerging regions with low cycling tradition, where social and infrastructural gaps may endanger the cyclists' safety. OBJECTIVES: This study had two objectives. First, to compare key safe cycling-related variables between cycling commuters and non-commuters; and second, to differentially asses the effect of individual and cycling-related variables on their self-reported crash rates. METHOD: For this cross-sectional research, the data provided by 577 Latin American urban cyclists from three countries (Argentina, Colombia and Mexico) with a mean age of 32.7 years was used. They answered a questionnaire on cycling habits, risk perception, rule knowledge, cycling behaviors and riding crashes. RESULTS: The outcomes of this study showed that, despite having a higher risk perception, cycling commuters perform deliberate risky cycling behaviors (traffic violations) more frequently, and they suffer more crashes; cycling commuters report higher rates of psychological distress, and a lower degree of rule knowledge and protective behaviors than non-commuters. Furthermore, structural similarities and differences in the explanation of cycling crashes were found across commuters and non-commuters. CONCLUSION: The results of this study suggest that non-commuters, whose purposes for cycling are more aimed at leisure and occasional trips, perform less risky behaviors but suffer more cycling distractions, whereas commuters are comparatively more exposed to behavioral-based safety risks, and suffer more frequent crashes. Since recent evidence forecasts that urban cycling will keep growing in Latin American cities, it is necessary to implement policies and educational/training improvements that may enhance the safety and health of cyclists in these countries.

Could Road Safety Education (RSE) Help Parents Protect Children? Examining Their Driving Crashes with Children on Board.

Recent evidence suggests that driving behavior and traffic safety outcomes of parents may be influenced by the extent to which they receive information and education on road safety, as well as the fact of driving with their children on board, which may increase their risk perception. However, there are no studies specifically addressing the case of crashes suffered while driving with children. Hence, this study aimed to describe the relationship between road safety education-related variables and parents' traffic safety outcomes while driving with children on board. For this cross-sectional study, data was retrieved from a sample composed of 165 Spanish parents-all of them licensed drivers-with a mean age of 45.3 years. Through binary logistic regression (logit) analysis, it was found that factors such as gender, having received road safety education (RSE), and having been sanctioned for the performance of risky driving behavior contribute to modulating the likelihood of suffering crashes while driving with children on board. Gender differences showed a riskier status for male parents. In this study, a set of risk factors explaining the involvement in traffic crashes when driving with children as passengers was identified among parents: gender, traffic sanctions, valuation, and exposure to road safety campaigns. Also, substantial limitations in the self-reported degree of received RSE were found, especially considering that risky driving behavior and traffic crash rates with children on board still have a high prevalence among parents.

Lifestyle in Undergraduate Students and Demographically Matched Controls during the COVID-19 Pandemic in Spain.

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 + 8.1 vs. 77.2 + 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles.

Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey.

BACKGROUND: This study aimed to compare self-reported changes on lifestyle behaviors during two phases of the COVID-19 pandemic in Spain, and to evaluate clinical and sociodemographic factors associated with lifestyles. METHODS: Two cross-sectional web surveys were conducted during lockdown (April 15-May 15, 2020) and seven months later (November 16-December 16, 2020). Lifestyle behaviors were self-reported by a multidimensional scale (SMILE-C). Two separate samples of respondents were analyzed. A multivariate regression model was performed to evaluate the association of SMILE-C scores with demographic and clinical variables. RESULTS: The sample comprised, 3412 participants from the first survey (S1) and in the S1 and 3635 from the second (S2). SMILE-C score decreased across surveys (p < 0.001). The rates of positive screenings for depression and anxiety were similar between the surveys, whereas those for alcohol abuse decreased (p < 0.001). Most participants in S2 reported that their lifestyle had not changed compared to those before the pandemic. Variables independently associated with an unhealthier lifestyle were working as an essential worker, lower educational level, previous mental disease, worse self-rated health, totally/moderate changes on diet, sleep or social support, as well as positive screenings for alcohol abuse, anxiety and depression. LIMITATIONS: The cross-sectional design and recruitment by non-probabilistic methods limit inferring causality and the external validity of the results. CONCLUSIONS: Overall lifestyle worsened seven months after the lockdown in Spain. Several demographic and clinical factors were associated with lifestyle scores. The contribution of common mental disorders to unhealthier lifestyles should be considered in order to prevent the negative impact of the pandemic.

Behavioral Health at School: Do Three Competences in Road Safety Education Impact the Protective Road Behaviors of Spanish Children?

Background: Education in road safety (also known as Road Safety Education-RSE) constitutes, nowadays, an emergent approach for improving present and future road behaviors, aiming at taking action against the current, and concerning, state-of-affairs of traffic crashes, through a behavioral perspective. In the case of children, and despite their overrepresentation in traffic injury figures, RSE-based strategies for behavioral health in transportation remain a "new" approach, whose impact still needs to be empirically tested. Objective: The aim of this study is to assess the impact of three key road safety skills of the Positive Attitudes, Risk perception and Knowledge of norms (PARK) model, addressed in RSE-based interventions, on the safe road behavior of Spanish children. Methods: For this cross-sectional study, a representative sample of 1930 (50.4% males and 49.6% females) Spanish children attending primary school, with a mean age of 10.1 (SD = 1.6) years, was gathered from 70 educational centers across all Spanish regions, through a national study on RSE and road safety. Results: Road safety skills show a positive relationship with children's self-reported safe behaviors on the road. However, the knowledge of traffic norms alone does not predict safe behaviors: it needs to be combined with risk perception and positive attitudes towards road safety. Furthermore, the degree of exposure to previous RSE interventions was shown to have an effect on the score obtained by children in each road safety skill; on the other hand, road misbehaviors observed in parents and peers had a negative impact on them. Conclusion: The outcomes of this study suggest that education in road safety is still a key process for the acquisition of safe habits, patterns and behaviors among young road users.

Job stress and emotional exhaustion at work in Spanish workers: Does unhealthy work affect the decision to drive?

OBJECTIVES: The purpose of this study was to assess the relationships among the following elements: unhealthy work indicators (job stress and emotional exhaustion at work), the decision to drive (or not), and driving crashes suffered by Spanish workers. METHODS: For this cross-sectional study, a full sample of 1,200 Spanish drivers (44% women and 56% men) was used, their mean age being 42.8 years. They answered a questionnaire divided into three sections: demographic and driving-related data; burnout, job stress, and life stress; and self-reported road behaviors and driving safety indicators. RESULTS: Overall, 41.6% of drivers reported emotional exhaustion at work. Furthermore, 80.2% of the participants showing substantial signs of job stress or exhaustion had experienced one or more important stressful life events during the previous year. Job stress was associated with the number of driving crashes suffered along the last 3 years. Also, and especially in situations where drivers admit not feeling well enough to drive, job stress and emotional exhaustion seem to be independent from the decision to drive, and from perceiving these variables as potential impairers of driving performance. CONCLUSIONS: First of all, this study showed a high prevalence of job stress and emotional exhaustion symptoms experienced at work by Spanish workers. Moreover, significant relationships were found among self-rated driving performance, workplace stress and burnout indicators, which suggests that job stress and emotional exhaustion levels may, indeed, impair driving performance, but they do not influence the decision to drive or not. In other words, even when they are significantly affected by job stress or emotional exhaustion at work, most Spanish drivers still drive.

Importance of Social- and Health-Related Problems: Do Spaniards Give Them the Significance They Actually Deserve?

Social and health problems imply an impact on society. The main objective of this study is to provide an overview of how Spanish people perceive cancer, terrorism, cardiovascular diseases, crime, AIDS, drugs, and traffic accidents, finding out whether they assess the importance of these issues in correspondence with their actual severity. The study used a full sample of 1206 Spaniards (51.6% females and 48.4% males) who responded to a computer-assisted telephone interviewing (CATI) survey on the significance of these social and health-related problems, assessed through a zero to ten Likert scale. The perceived severity of the problems was considered taking into account the official data of deaths reported by governmental institutions. For the comparison of mean values, the One-way Analysis of Variance (ANOVA) test was used. Results show high average values for all the problems. The most concerning elements are cancer (M = 9.28 ± 1.24) and terrorism (M = 9.22 ± 1.47). Cardiovascular diseases have the lowest scores (M = 8.29 ± 1.64). There is a good adjustment between real and subjective perception, but some issues are either underestimated or overestimated. Women assessed all of them as more important than men, and people over 65 gave all the issues more value than younger people. It is important that Spaniards understand the objective severity of these issues, thus allowing for more interventions by governments, education, and mass media.

The observation period after clinical brain death diagnosis according to ancillary tests: differences between supratentorial and infratentorial brain injury.

OBJECTIVE: To determine the optimal observation period (OBP) in adults with a clinical diagnosis of brain death (BD) using electroencephalography (EEG) or computerized tomography angiography (CTA). METHODS: We conducted a retrospective observational analysis of adult patients with a diagnosis of BD from January 2000 to February 2017. The optimal OBP was defined as the minimum time interval from the first complete clinical neurological examination (CNE) that ensures that neither a second CNE nor any ancillary test (AT) performed after this period would fail to confirm BD. RESULTS: The study sample included 447 patients. In the supratentorial group, the first AT confirmed BD in 389 cases (98%), but in 8 (2%) cases the complementary test was incongruent. In this group, 8 of 245 patients in whom the first AT was carried out within the first 2 h after a complete CNE had a non-confirmatory test of BD versus none of 152 in whom the first AT was delayed more than 2 h (3.0% vs 0.0%; p = 0.026). In the infratentorial group, we found a higher probability of obtaining a first non-confirmatory AT of BD (34% vs 2%; p = 0.0001) and an OBP greater than 32.5 h was necessary to confirm a BD diagnosis. CONCLUSIONS: We found important differences in the confirmation of BD diagnosis between primary supratentorial and infratentorial lesion, and identified an optimal OBP of 2 h in patients with supratentorial lesions. By contrast, in primary posterior fossa/infratentorial lesions, the determination of an optimal OPB remains less accurate and hence more challenging.

Growth hormone (GH) dose, but not exon 3-deleted/full-length GH receptor polymorphism genotypes, influences growth response to two-year GH Therapy in Short Small-for-Gestational-Age Children.

CONTEXT: In short small-for-gestational-age (SGA) patients, the exon 3-deleted(d3)/full-length (fl)-GHR polymorphism was associated with responsiveness to GH therapy (30-48 microg/kg.d); however, these results were not confirmed for higher GH doses (56-66 microg/kg.d). We hypothesized that higher doses would mask the lower dose differences. OBJECTIVE: Our objective was to evaluate, in short SGA patients, 2-yr growth response to GH therapy (32.1 +/- 3.8 microg/kg.d) according to exon d3/fl-GHR genotypes. SETTING: This was a 2-yr follow-up study. PATIENTS: There was a total of 60 short SGA children (d3/d3 n = 8, d3/fl n = 23, and fl/fl n = 29). There were 11 children that entered puberty during the second follow-up year. Results were evaluated for all patients (group A1, n = 60, 7.7 +/- 2.7 yr) and for patients who remained prepubertal (group A2, n = 49, 6.9 +/- 2.2 yr). MAIN OUTCOME MEASURES: Patients were followed by a single clinical team, and exon d3/fl-GHR genotypes were determined and analyzed in the same hospital. RESULTS: In groups A1 and A2, growth velocity significantly (P < 0.0001) increased during the first and second years of therapy, as did height sd score (SDS). These increases were similar in each exon d3/fl-GHR genotype. Total 2-yr height gain (cm, SDS) did not differ statistically among genotypes: group A1, 15.0 +/- 2.0 cm and 1.15 +/- 0.45 SDS in d3/d3, 16.0 +/- 2.4 cm and 1.17 +/- 0.51 SDS in d3/fl, 16.1 +/- 2.4 cm and 1.15 +/- 0.53 SDS in fl/fl; and group A2, 15.4 +/- 2.0 cm and 1.03 +/- 0.42 SDS in d3/d3, 15.6 +/- 2.1 cm and 1.22 +/- 0.51 in d3/fl, and 16.2 +/- 2.6 cm and 1.21 +/- 0.56 SDS in fl/fl. CONCLUSIONS: These results did not confirm our hypothesis and show that, in short SGA children, 2-yr growth response to GH therapy 32.1 +/- 3.8 microg/kg.d was similar for each exon d3/fl-GHR genotype carried, as occurred in our previous study using 66 microkg.d.

Distraction of cyclists: how does it influence their risky behaviors and traffic crashes?

BACKGROUND: Undisputedly, traffic crashes constitute a public health concern whose impact and importance have been increasing during the past few decades. Specifically, road safety data have systematically shown how cyclists are highly vulnerable to suffering traffic crashes and severe injuries derived from them. Furthermore, although the empirical evidence is still very limited in this regard, in addition to other human factors involved in cycling crashes, distractions while cycling appear to be a major contributor to the road risk of cyclists. OBJECTIVES: The main objectives of this study were, first, to explore the prevalence and trends of cycling distractions within an international sample of bike users, and second, to determine the influence of such distractions on road crashes suffered by cyclists, simultaneously considering the explanatory role of risky behaviors (errors and traffic violations) as potentially mediating variables between cycling distractions and traffic crashes. METHODS: For this cross-sectional study, we analyzed the data obtained from 1,064 cyclists-61.2% male and 38.8% female-from 20 different countries, who answered an on-line questionnaire on cycling-related features, habits, behaviors and accidents. RESULTS: The prevalence of different cycling distractions oscillated between 34.7% and 83.6%. The most common distractions were those related to the behavior of other users, physical elements of the road, weather conditions and phone calls. Age trends and differences were also found, thus establishing a positive association between age and distractibility during cycling. Furthermore, the effect of distractions on traffic crashes of cyclists was significant when tested together with age, risk perception and risky behaviors on the road. CONCLUSION: The results of this study support the hypotheses that distractions have a major prevalence among bike users, and that they play a significant role in the prediction of the traffic crash rates of cyclists, through the mediation of risky behaviors.

Work stress and health problems of professional drivers: a hazardous formula for their safety outcomes.

BACKGROUND: Several empirical studies have shown that professional drivers are a vulnerable occupational group, usually exposed to environmental stressors and adverse work conditions. Furthermore, recent studies have associated work-related stress with negative job performances and adverse health outcomes within this occupational group, including cardiovascular diseases and unsafe vehicle operation. OBJECTIVE: The aim of this study was to describe the working conditions and the health status of this occupational group, and to evaluate the association between the Demand-Control model of job stress and their self-reported health and safety outcomes. METHODS: A pooled sample of 3,665 Colombian professional drivers was drawn from five different studies. The Job Content Questionnaire and the General Health Questionnaire were used to measure work stress and self-reported mental health, respectively. Additionally, professional drivers self-reported health problems (hypertension, dyslipidemia, diabetes and overweight) and health-related risky behaviors (smoking and sedentary behavior). RESULTS: Regarding the Job Demands-Control (JDC) model, it was found that approximately a third part of Colombian professional drivers suffer from high job strain (29.1%). Correlational and multivariate analyses suggest that de JDC model of stress is associated with the professional drivers' mental health, traffic accidents and fines, but not with other physical and behavioral health-related outcomes, which are highly prevalent among this occupational group, such as hypertension, dyslipidemia, diabetes, overweight, smoking and sedentary behavior. CONCLUSION: The results of this study suggest that (a) stressful working conditions are associated with health and lifestyle-related outcomes among professional drivers, and (b) that evidence-based interventions are needed in order to reduce hazardous working conditions, job stress rates and their negative impact on the health of this occupational group.

Effect of Road Safety Education on Road Risky Behaviors of Spanish Children and Adolescents: Findings from a National Study.

BACKGROUND: Road Safety Education (RSE) is widely known as a reliable determinant of the future results for what concerns health and welfare and as an undisputable factor which contributes to the social behavior of individuals and to their mid- and long-term road safety outcomes. However, its development has been relatively scarce in most countries, a fact which has contributed to letting matters as delicate as traffic crashes, largely explained by road misbehaviors, continue to be a prevalent problem, thus affecting the health of the community. OBJECTIVE: The aim of this study was to describe the relationship between demographic and RSE-related variables and the self-reported road risky behavior of Spanish students. METHODS: For this cross-sectional study, a representative sample of 4062 (51.5% males and 48.5% females) participants attending primary (47.5%), secondary (40.7%), and high school (11.7%) was gathered through a national survey on RSE and road behaviors. RESULTS: A set of significant associations between demographic factors, RSE variables, and self-reported road behaviors was found. Furthermore, Structural Equation Modelling (SEM) allowed us to establish that age and observed misbehaviors (positively), and attitudes towards road safety and risk perception (negatively), have a direct link with the road risky behavior of children and young people. The knowledge of traffic rules was not a significant predictor of road behavior. CONCLUSIONS: The results of this study show that, together with demographic factors such as age, RSE-related variables have an effect on the road behavior of children and young people. They also suggest the need for strengthening actions to be implemented in road safety (Road Safety Education) at scholar and community levels.

Exon 3-deleted/full-length growth hormone receptor polymorphism genotype frequencies in Spanish short small-for-gestational-age (SGA) children and adolescents (n = 247) and in an adult control population (n = 289) show increased fl/fl in short SGA.

CONTEXT: A polymorphism in the human GH receptor gene (d3/fl-GHR) resulting in genomic deletion of exon 3 has been associated with the degree of height increase in response to GH therapy. OBJECTIVE: The objective of the study was to evaluate the frequencies of d3/fl-GHR polymorphism genotypes in control and short small-for-gestational-age (SGA) populations. DESIGN: An adult control population with heights normally distributed (ACPNH) between -2 and +2 sd score (SDS) and a short non-GH-deficient SGA child population were selected. SETTING: Thirty Spanish hospitals participated in the selection of the short non-GH-deficient SGA children in the setting of a controlled, randomized trial, and one of these hospitals selected the ACPNH. CONTROLS AND PATIENTS: Two hundred eighty-nine adult subjects of both sexes constituted the ACPNH and 247 children and adolescents of both sexes the short SGA patients. MAIN OUTCOME MEASURES: Heights and weights were recorded in the ACPNH, and auxologic and biochemical data were recorded at each hospital for the SGA patients; d3/fl-GHR genotypes were determined and data analyzed in a single hospital. RESULTS: In short SGA patients, d3/fl-GHR genotype frequencies were significantly different from those in ACPNH, with a higher frequency of fl/fl genotype (P < 0.0001). In ACPNH, a trend toward diminished d3/d3 genotype frequency was observed in the shortest height group (height or=-2 SDS, n = 60). CONCLUSIONS: Our data showed significant differences in the frequency distribution of the d3/fl-GHR genotypes between a normally distributed adult height population and short SGA children, with the biologically less active fl/fl genotype being almost twice as frequent in SGA patients. These data suggest that the d3/fl-GHR polymorphism might be considered among the factors that contribute to the phenotypic expression of growth.