Are Spanish Surveys Ready to Detect the Social Factors of Obesity?

The social origins of obesity are now recognised: a problem that is initially biological is today a public health problem with a social origin. This paper raises the question of whether the official statistical sources used to understand changes in diet are able to detect this shift in analysis. After reviewing the social factors that explain obesity, we examine the official Spanish statistics that can inform about dietary changes: the ENS National Health Survey, the EPF Family Budget Survey, and the EET Time Use Survey, all carried out by the Spanish Statistical Office. All of them include socio-demographic variables and some locational variables. However, the lack of health variables in the economic survey and the lack of social variables in the health survey prevent the gathering of reliable scientific evidence to offer solid support in stopping the obesity epidemic. Food has become particularly important as one of the main areas where unhealthy decisions and choices involve high risk; the situation also demonstrates the relationship between social inequality and obesity. Obesity is now understood in a radically different way and the origin of the problem lies in social and cultural factors. The current surveys do not provide the resources to capture the social causality of obesity, but slight modifications would help expand their capabilities and offer reliable scientific evidence to stop the obesity epidemic.

Well-Being and the Lifestyle Habits of the Spanish Population: The Association between Subjective Well-Being and Eating Habits.

The so-called Mediterranean diet is not simply a collection of foodstuffs but an expression of the culture of the countries of the south of Europe, declared Intangible Cultural Heritage by UNESCO. Despite the link between food and culture, little has been studied about how diet contributes to the well-being of the population. This article aims to analyze the association between subjective well-being and the eating habits of the Spanish population in order to gain a better understanding of the subjective well-being that food culture produces. For this study, we used a representative sample of the Spanish adult population from a survey by the Sociological Research Center (CIS 2017). Three indicators of subjective well-being were used: perceived health, life satisfaction, and feeling of happiness. The independent variables relating to eating habits considered in the analysis were, among others, how often meat, fish, vegetables, fruit, and sweets were consumed; how the food was prepared; how often meals were eaten out at restaurants or cafés and how often they were eaten with family or friends. Other independent variables related to lifestyle habits were also included in the analysis, in particular, physical exercise and body mass index. We used ordinal logistic regressions and multiple linear regression models. Our findings coincide in large measure with those obtained in earlier studies where perceived health and income play a key role in evaluating subjective well-being. In turn, several variables related to lifestyle habits, such as consuming sweets and fruits, social interaction around meals, exercising, and body mass index, were also associated with subjective well-being.

The combined used of quantitative and qualitative longitudinal methods in the study of obesity.

OBJECTIVE: To explore the combined use of quantitative and qualitative methods with a longitudinal perspective in the field of obesity diet and physical activity. METHOD: A systematic scoping review following PRISMA guidelines. The databases searched were Web of Science, PubMed, and ASSIA. RESULTS: 1592 records were returned from the searches. In total, nine studies met the inclusion criteria and were included in the review. Authors of included studies mixed quantitative and qualitative methods to obtain a deeper understanding of their study subjects, but few documents use longitudinal data. Authors value the combination of methods and try to integrate the results in their conclusions. CONCLUSIONS: Total integration is rarely achieved in the analysis. The origin of this divergence can be found in the lack of theoretical guidance in these articles, but also in the difficulty of working in multidisciplinary teams in the field of obesity.

Chronic nonbacterial osteomyelitis in children: a multicenter case series.

Chronic nonbacterial osteomyelitis (CNO) is a primary autoinflammatory bone disease that presents more frequently in children and is characterized by inflammatory bone lesions in the absence of an infectious etiology. There is little information of this disease in Latin America. The objective of the study was to evaluate demographic, clinical, laboratory, imaging, histopathology characteristics, and treatment responses of pediatric CNO patients. The clinical records of 19 patients with CNO diagnosed between 2007 and 2019 at three tertiary centers in Santiago, Chile were reviewed. The median age of onset was 10 years and 47% were female. Median delay in diagnosis was 12 months. All patients had a pattern of recurrent multifocal disease. 37% of patients had positive antinuclear antibodies and 16% HLA-B27 positivity. 21% of patients presented arthritis or other rheumatologic comorbidity, although no association with psoriasis, inflammatory bowel disease (IBD) or palmoplantar pustulosis (PPP) was observed. Eighteen patients received treatment with nonsteroidal anti-inflammatory drugs with partial response. Twelve patients received methotrexate, and half of them received steroids at the same time reaching remission in 50%. Of the five patients who received bisphosphonates, 60% achieved remission. All four patients who received adalimumab had comorbid arthritis and 75% achieved remission. In a series of Chilean children with CNO, all patients presented with multifocal lesions. Comorbid autoimmune diseases including arthritis were frequent, but no association was observed with psoriasis, IBD, or PPP.

[Nutrition and gastronomy in the Principality of Asturias]. / Nutrición y gastronomía en el Principado de Asturias.

INTRODUCTION: Introduction: Asturias is renowned for its beautiful and diverse nature and landscapes and for its rich gastronomic tradition. Objectives: to understand the traditional gastronomic identity of Asturias and its relationship with food and nutritional intake and health indicators of the population. Methods: bibliographic search (PubMed, Google Scholar) with different combinations of keywords. Results: the gastronomic tradition of Asturias is characterized by a great variety of foods and dishes, with emblematic culinary preparations. Different reports and studies agree that it is one of the Spanish Regions with the highest food consumption, except for vegetables and cereals and derivatives. The energy intake is also among the highest, but with the highest rates of diet quality indexes. The high consumption of food and the high energy intake, together with an aged population with a high prevalence of sedentary lifestyles, could explain that the prevalence of obesity in the adult population of Asturias is the highest of all the Spanish Regions, with an increasing incidence of diabetes. Conclusions: it is necessary to implement public health policies aimed at improving food selection and health indicators. Furthermore, the study of the contribution of traditional dishes to the dietary habits, the nutritional intake and the health indicators of the population of Asturias would help in improving food selection.

INTRODUCCIÓN: Introducción: Asturias es reconocida por su riqueza natural y paisajística y por su rica tradición gastronómica. Objetivos: conocer la identidad gastronómica tradicional de Asturias y su relación con los hábitos de consumo alimentario, la ingesta nutricional y los indicadores de salud de la población. Métodos: búsqueda bibliográfica (PubMed, Google Scholar) con distintas combinaciones de las palabras clave. Resultados: Asturias tiene una gastronomía caracterizada por una gran variedad de alimentos y platos, con preparaciones culinarias emblemáticas. Distintos informes y estudios coinciden en que es una de las comunidades autónomas con mayor consumo y gasto per cápita en alimentación, a pesar de lo cual está entre las de menor consumo de verduras, hortalizas y cereales y derivados (excepto el pan). La ingesta energética está también entre las más altas, si bien el perfil calórico y el perfil lipídico muestran los valores más cercanos a las recomendaciones. El elevado consumo de alimentos y la alta ingesta energética, unidos al envejecimiento poblacional y al elevado sedentarismo, podrían explicar que la prevalencia de obesidad en la población adulta de Asturias sea la más alta de todas las comunidades autónomas, con una creciente incidencia de diabetes. Conclusiones: se hace necesaria la implementación de políticas públicas de salud orientadas a la mejora de la selección de alimentos, así como el estudio de la contribución de los platos tradicionales al conjunto de los hábitos alimenticios y de la ingesta de energía y nutrientes de la población asturiana.

Nutrición y gastronomía en el Principado de Asturias / Nutrition and gastronomy in the Principality of Asturias

Introducción: Asturias es reconocida por su riqueza natural y paisajística y por su rica tradición gastronómica. Objetivos: conocer la identidad gastronómica tradicional de Asturias y su relación con los hábitos de consumo alimentario, la ingesta nutricional y los indicadores de salud de la población. Métodos: búsqueda bibliográfica (PubMed, Google Scholar) con distintas combinaciones de las palabras clave. Resultados: Asturias tiene una gastronomía caracterizada por una gran variedad de alimentos y platos, con preparaciones culinarias emblemáticas. Distintos informes y estudios coinciden en que es una de las comunidades autónomas con mayor consumo y gasto per cápita en alimentación, a pesar de lo cual está entre las de menor consumo de verduras, hortalizas y cereales y derivados (excepto el pan). La ingesta energética está también entre las más altas, si bien el perfil calórico y el perfil lipídico muestran los valores más cercanos a las recomendaciones. El elevado consumo de alimentos y la alta ingesta energética, unidos al envejecimiento poblacional y al elevado sedentarismo, podrían explicar que la prevalencia de obesidad en la población adulta de Asturias sea la más alta de todas las comunidades autónomas, con una creciente incidencia de diabetes. Conclusiones: se hace necesaria la implementación de políticas públicas de salud orientadas a la mejora de la selección de alimentos, así como el estudio de la contribución de los platos tradicionales al conjunto de los hábitos alimenticios y de la ingesta de energía y nutrientes de la población asturiana

Introduction: Asturias is renowned for its beautiful and diverse nature and landscapes and for its rich gastronomic tradition. Objectives: to understand the traditional gastronomic identity of Asturias and its relationship with food and nutritional intake and health indicators of the population. Methods: bibliographic search (PubMed, Google Scholar) with different combinations of keywords. Results: the gastronomic tradition of Asturias is characterized by a great variety of foods and dishes, with emblematic culinary preparations. Different reports and studies agree that it is one of the Spanish Regions with the highest food consumption, except for vegetables and cereals and derivatives. The energy intake is also among the highest, but with the highest rates of diet quality indexes. The high consumption of food and the high energy intake, together with an aged population with a high prevalence of sedentary lifestyles, could explain that the prevalence of obesity in the adult population of Asturias is the highest of all the Spanish Regions, with an increasing incidence of diabetes. Conclusions: it is necessary to implement public health policies aimed at improving food selection and health indicators. Furthermore, the study of the contribution of traditional dishes to the dietary habits, the nutritional intake and the health indicators of the population of Asturias would help in improving food selection

Social Inequalities in Following Official Guidelines on Healthy Diet During the Period of Economic Crisis in Spain.

In Spanish society, social inequalities continue in connection with diet; however, no data examines whether these inequalities altered during the period of economic crisis. This article aims to analyze trends in inequalities related to adherence to government guidelines concerning healthy diet during the period of economic crisis based on the data obtained from the National Health Surveys conducted by the National Statistics Institute. The approach involves studying first the data from the 2006 survey, shortly before the crisis, and then comparing these with the data from the 2011-2012 survey. Applying models of logistic regression shows that certain social inequalities were accentuated by the crisis. However, the general and widespread pattern of eating habits does not disappear in times of crisis. Inequalities are more commonly seen when socioeconomic factors affect foods that the guidelines indicate should be eaten daily. However, with respect to more expensive products, socioeconomic factors did not have so much negative effect on how far a healthy diet was followed because it is recommended that consumption of these foods should be limited. The results suggest that food policy should have specific focuses during times of economic recession.

Eating out in Spain: Motivations, sociability and consumer contexts.

Eating out is a consumer practice which is difficult to define. The study of this practice has traditionally been based on the work/leisure dichotomy. However, in Spain this is not so clear. If we analyse profiles, motivations, places and relationships, we discover an eating-out food model which is specific to Spain and in which food is not limited by this dual link with work and leisure. Eating linked to work does not respond only to instrumental needs. Leisure eating is not always a choice based on preference. Both contain a strong element of sociability which acts as a motivator and are linked to the familisme of Spanish society, whilst at the same time de-routinizing daily life, both at home and at work. This study is based on a national survey carried out in 2014 and helps to understand this consumer practice and those elements which are specific to Spain.

Guía clínica GES de artritis idiopática juvenil 2014 / 2014 GES clinical guideline of juvenile idiopathic arthritis

La artritis idiopática juvenil (AIJ) ha sido definida por la Liga Internacional de Asociaciones de Reumatología (ILAR) como artritis de etiología desconocida que se inicia antes de los 16 años y dura por al menos seis semanas, habiendo excluido otras condiciones conocidas. La AIJ es una enfermedad cubierta por el sistema de Garantías Explícitas en Salud (GES) del Ministerio de Salud de Chile desde 2010. La presente guía, desarrollada por el Grupo Pediátrico de la Sociedad Chilena de Reumatología, consiste en una actualización de la Guía Clínica de AIJ 2010, incorporando nuevos protocolos terapéuticos y medicamentos que han demostrado un claro beneficio para niños con AIJ...

Juvenile idiopathic arthritis (JIA) has been defined by the International League of Associations for Rheumatology as arthritis of unknown etiology that begins before the sixteenth birthday and persists for at least 6 weeks with other known conditions excluded. JIA is a disease that is covered by the Explicit Health Guarantees system of the Chilean Ministry of Health since 2010. The present guideline developed by the Pediatric Group of the Chilean Rheumatology Society is an update of the 2010 JIA Clinical Guideline incorporating new treatment protocols and medications that have demonstrated clear benefits in children with JIA...

Tablas percentiles de peso al nacer y diagnóstico de retardo de crecimiento intrauterino en el Hospital Regional de Ica, 2010-2011 / Percentile tables weight at birth and diagnosis of intrauterine growth retardation in the Regional Hospital in Ica, 2010-2011

Objetivo: Con el objeto de valorar las diferentes tablas de curvas percentiles de peso usadas en nuestro medio para el diagnóstico nutricional de los recién nacidos en el Hospital regional de Ica, sobre todo de los desnutridos. Material y métodos. Fueron evaluadas 830 madres con sus recién nacidos, a los que se pesó, tallo y calculó su edad gestacional; catalogandolos luego como: con peso adecuado, pequeño o grande para su edad gestacional, priorizando pequeños para Edad Gestacional; para ello se usaron 6 tablas percentiles, posteriormente se compararon los resultados con cada una de ellas. Resultados. Hubieron diferencias significativas en el diagnostico nutricional, la tabla NACIONAL permitió identificar 16, 36% PEG, la concordancia fue alta entre las tablas NACIONAL con las de LIMA Y TACNA (0,87 Y 0,90), al usar la tabla NACIONAL como patrón de oro la de TACNA y de LIMA dieron los más adecuados cocientes de probabilidad positivo y negativo (CP+ 45,93 y CP- 0,08 la de TACNA); las  reas bajo la curva ROC fueron también mayores con las tablas de TACNA (0,986) y LIMA (0,980). Conclusión: Podría adoptarse la tabla percentilar NACIONAL o la de TACNA, aunque se debe considerar la elaboración de tablas locales dadas las diferencias encontradas.

Objective. With the objective of assessing the different tables of percentile curves used in our circlefor the nutritional diagnostic of newborns in the Regional Hospital in Ica, Especially for the undernourished. Material and methods: Were evaluated 830 mothers with their newborns, who are weight, stem and calculated their gestational age; cataloguethen as: with proper weight, small or large for gestational age, prioritizing small for gestational age; for it were used 6 percentile tables were then compared the results with each one of them. Results: There were significant differences in the nutritional diagnostic, the NATIONAL table allowed us to identify 16,36% PEG, the concordance was high among the tables with the national of Lima and Tacna (0.89 and 0.90), when using the tables as NATIONAL pattern of the gold of Tacna and LIMA gave the most were also higher with the tables of Tacna (0.986) and LIMA (0.980). Conclusion: The percentile table could be taken or the NATIONAL percentile of Tacna, although it should beconsidered the development of local tables given the differences found.

Erase una vez un niño. El valor del juego en la cura / There was once a child. The value of the Cure Game

A través del presente trabajo, planteamos la eficacia del juego como herramienta terapéutica a partir de un caso clínico de un niño de 5 años al momento de la consulta. El juego tiene una función de estructuración subjetiva mediante el cual se puede transformar el padecimiento. Gracias a esta función, el juego es un medio del que el analista se sirve para realizar el pasaje de la identificación de mente a la identificación lúdica. Para realizar este pasaje, es necesario poder desidentificarse de esos lugares signados por los otros (Mannoni, O., 1979), ya que estos asignan al sujeto un lugar en el deseo del otro. El juego, en tanto instrumento entre el sujeto y el mundo, le permite al sujeto historizarse, y al mismo tiempo separarse de esos lugares signados.

Through this work we question the effectiveness of play as therapeutic tool from acase of a 5 year old at the time of consultation. The game has a subjective structuring function by which you can transform the suffering. With this feature, the game is half of the analyst is served for the passage of identifying mind to identification playful. To make this passage, it is necessary to dis-identify with these places marked by the other (Mannoni, O., 1979), because these map to the subject a place in the other's desire. The game, as an instrument between the subject and the world, allows the subject historicizing, while unsigned separated from those places.

Erase una vez un niño. El valor del juego en la cura / There was once a child. The value of the Cure Game

A través del presente trabajo, planteamos la eficacia del juego como herramienta terapéutica a partir de un caso clínico de un niño de 5 años al momento de la consulta. El juego tiene una función de estructuración subjetiva mediante el cual se puede transformar el padecimiento. Gracias a esta función, el juego es un medio del que el analista se sirve para realizar el pasaje de la identificación de mente a la identificación lúdica. Para realizar este pasaje, es necesario poder desidentificarse de esos lugares signados por los otros (Mannoni, O., 1979), ya que estos asignan al sujeto un lugar en el deseo del otro. El juego, en tanto instrumento entre el sujeto y el mundo, le permite al sujeto historizarse, y al mismo tiempo separarse de esos lugares signados.(AU)

Through this work we question the effectiveness of play as therapeutic tool from acase of a 5 year old at the time of consultation. The game has a subjective structuring function by which you can transform the suffering. With this feature, the game is half of the analyst is served for the passage of identifying mind to identification playful. To make this passage, it is necessary to dis-identify with these places marked by the other (Mannoni, O., 1979), because these map to the subject a place in the others desire. The game, as an instrument between the subject and the world, allows the subject historicizing, while unsigned separated from those places. (AU)

Guía de tratamiento de la artritis idiopática juvenil / Treatment guide of juvenile idiopathic arthritis

Las artritis inflamatorias del niño constituyen un grupo heterogéneo de enfermedades de presentaciones clínicasdiversas y distintas bases genéticas. Esto ha hecho necesario desarrollar protocolos para el mejor manejo de estos cuadros. En este artículo el Grupo Pediátrico de la Sociedad Chilena de Reumatología ha propuesto una Guía clínica de tratamiento de la Artritis Idiopática Juvenil según los actualesCriterios de Clasificación de ILAR (International League of Associatons for Rheumatology), Edmonton 2001.

Inflammatory arthritis in children is a heterogeneous disease group with several clinical signs and different genetic background. This has brought about the need to develop clinical trials to improve disease management. In this article, the Pediatric Group of the Chilean Rheumatology Society has proposed a Clinical Guide for the medical treatment of Juvenile Idiopathic Arthritis, based on the latest Classification Criteria of the International League of Associations for Rheumatology, ILAR, Edmonton 2001.

[Skin prick test of immediate hypersensitivity in a selected Chilean pediatric population sample]. / Pruebas cutáneas de hipersensibilidad inmediata en una población pediátrica seleccionada.

BACKGROUND: Skin prick test (SPT) of immediate hypersensitivity is a main instrument in the diagnosis of allergy. AIM: To demonstrate the applicability of skin prick test in different age groups. PATIENTS AND METHODS: We studied children and adolescents with the diagnosis of allergy in the Pediatric Respiratory Laboratory of the Catholic University of Chile, from January 2001 to March 2002. The SPT was performed using a standardized technique. The allergens were applied on the volar surface of the forearm in children older than 4 years of age and in younger children it was applied on their back. For study purposes we separated them into three age groups: GI < or =2 years and 11 months, GII from 3 to 4 years and 11 months, GIII > or =5 years. RESULTS: We studied 408 children, aged between 8 months and 15 years. The SPT was applied to all patients with no adverse effects of any kind. There was a positive reaction in 57.7% of children. The reaction was positive in 37% in G1, 39% in GII and 65% in GIII (p <0.001). The predominant allergens for each group were dust mites (Dermatophagoides pteronissinus and farinae). CONCLUSIONS: SPT was useful when used on a selected pediatric population. The frequency of sensitization increased significantly with age. However, more than one third of children between 2 and 4 years of age tested positive to one or more allergen, demonstrating its applicability in this age group.

[Clinical findings and immunologic variability in 9 patients with DiGeorge syndrome]. / Manifestaciones clínicas y variabilidad inmunológica en nueve pacientes con síndrome de DiGeorge.

BACKGROUND: DiGeorge syndrome is characterized by developmental defects of the heart, parathyroid glands and thymus. AIM: To describe the clinical variability of DiGeorge syndrome and its relation with immunodeficiency. PATIENTS AND METHODS: A three years retrospective chart review from three hospitals of Santiago, Chile was conducted. We included patients with neonatal diagnosis of DiGeorge syndrome. Clinical and immunologic data were collected from their initial evaluation. RESULTS: We found 9 patients with DiGeorge syndrome. All had dysmorphic facies, hypocalcemia and congenital heart disease. Three patients had hypoparathyroidism, 4 had interrupted aortic arch type B, 4 had tetralogy of Fallot and 1 had coarctation of aorta. Six patients had other malformations and associated diseases. FISH studies, performed in 8 patients, found the 22q11.2 microdeletion in all. Most patients had low CD3, CD4 and CD8 T cell counts, that ranged for CD3 T cells, between 256/mm3 and 3,664/mm3, for CD4 T cells, between 224/mm3 and 2,649/mm3, for CD8 T cells, between 26/mm3 and 942/mm3. Three patients had CD4 T cells counts <400/mm3 and one had a phytohemagglutinin stimulation index <10. Airway malformations and primary hypoparathyroidism were present in 3 out of 4 patients that died before 18 months compared with the surviving patents (p=0.048). CONCLUSIONS: We found variable clinical manifestations as well as CD3, CD4 and CD8 T cell counts in patients with DiGeorge syndrome. Airway malformations were associated with a higher mortality.

Mild cognitive impairment: new neuropsychological and pharmacological target.

Mild cognitive impairment (MCI) is increasingly being conceptualized in the literature as a cognitive disturbance representing a transitional phase between normal aging and dementia. The operational definitions of MCI provide an opportunity for neuropsychologists to detect subtle deficit and monitor cognitive status sequentially in order to determine rate and degree of progression. More importantly, clinical and neuropsychological studies are needed that can better characterize which MCI patients are at greatest risk for conversion to dementia. Preliminary data has also designated MCI as a potential indicator for initiation of pharmacotherapy, with the objective of decelerating rate of progression to dementia. Current criteria and clinical issues related to MCI are discussed, with the objective of better familiarizing clinicians with this syndrome and fostering ongoing investigations.