Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil.

BACKGROUND: The scale-up of parenting programmes to support early childhood development (ECD) is poorly understood. Little is known about how and when early interventions are most effective. Sustainability of ECD programming requires a better understanding of the mechanisms of real-world interventions. We examined the effects on caregiving practices of Primeira Infância Melhor (PIM), a state-wide home-visiting programme in Brazil. METHODS: This propensity score matched, longitudinal, quasiexperimental study uses data from the 2015 Pelotas Birth Cohort. We matched children who received PIM at any age with other cohort children on 25 key covariates. Sensitivity, guidance and responsiveness were assessed using video-recorded play tasks. Coerciveness and the parent-child relationship were assessed using the Parenting and Family Adjustment Scales. All parenting outcomes were examined at age 4 years. Separate moderation analyses were conducted for each effect modifier: family income, child age and duration of participation. RESULTS: Out of 4275 children in the cohort, 797 were enrolled in PIM up to age 4 years. 3018 children (70.6%) were included in the analytic sample, of whom 587 received PIM and 2431 were potential controls. We found a positive effect of PIM on responsiveness (ß=0.08, 95% CIs 0.002 to 0.16) and sensitivity (ß=0.10, 95% CIs 0.02 to 0.19). No effect was found for any secondary outcomes. Moderation analyses revealed a stronger positive effect on sensitivity for low-income parents (ß=0.18, 95% CIs 0.03 to 0.34). CONCLUSION: A state-wide, home-visiting programme in Brazil improved aspects of responsive caregiving. Effects were more pronounced for low-income families, suggesting benefits of purposeful targeting.

A comprehensive and healthcare equity promoting response by a civil society-public partnership to COVID-19 in Chiapas, Mexico.

Following the first COVID-19 case in Chiapas, Mexico in March 2020, the non-governmental organisation Compañeros En Salud (CES) and the state's Ministry of Health (MOH) decided to join forces to respond to the global pandemic. The collaboration was built over 8 years of partnership to bring healthcare to underserved populations in the Sierra Madre region. The response consisted of a comprehensive SARS-CoV-2 infection prevention and control programme, which included prevention through communication campaigns to combat misinformation and stigma related to COVID-19, contact tracing of suspected and confirmed COVID-19 cases and their contacts, outpatient and inpatient care for patients with respiratory symptoms, and CES-MOH collaboration on anti-COVID-19 immunisation campaigns. In this article, we describe these interventions and their principal outcomes, as well as reflect on notable pitfalls identified during the collaboration, and we suggest a series of recommendations to prevent and mitigate their occurrence. As with many cities and towns across the globe, the poor preparedness of the local health system for a pandemic and pandemic response led to the collapse of the medical supply chain, the saturation of public medical facilities and the exhaustion of healthcare personnel, which had to be overcome through adaptation, collaboration and innovation. For our programme in particular, the lack of a formal definition of roles and clear lines of communication between CES and the MOH; thoughtful planning, monitoring and evaluation and active engagement of the communities served in the design and implementation of health interventions affected the outcomes of our efforts.

Is the Relationship between Acute and Chronic Workload a Valid Predictive Injury Tool? A Bayesian Analysis.

This study aimed to evaluate the relationship between injury risk, acute load (AL), acute chronic workload ratio (ACWR) and a new proposed ACWR. DESIGN: a retrospective cohort study of the year 2018 was conducted on Argentine first-division soccer players. PARTICIPANTS: Data from 35 players (age = 26.7 ± 4.71 years; height = 176.28 ± 6.09 cm; mass = 74.2 ± 5.27 kg) were recorded; 12 players' data were analyzed for 1 year, and 23 players' data were analyzed for 6 months. INTERVENTIONS: The mean difference of ACWR (MD = 0.22), high-density interval (HDI 95% = (0.07, 0.36)) and AL (MD = 449.23, HDI 95% = (146.41, 751.2)) between groups turned out to be statistically significant. The effect size between groups comparing ACWR and AL was identical (ES = 0.64). RESULTS: The probability of suffering an injury conditioned by ACWR or random ACWR was similar for all estimated quantiles, and the differences between them were not statistically significant. CONCLUSIONS: The ACWR ratio, using internal load monitoring, is no better than a synthetic ACWR created from a random denominator to predict the probability of injury. ACWR should not be used in isolation to analyze the causality between load and injury.

Childhood obesity in Mexico: Influencing factors and prevention strategies.

Background: Overweight and obesity in school-age children, in Mexico as in other countries around the world, is a rapidly increasing public health problem within recent years, with important consequences for the future health of the population. Various national strategies at the individual and community level have been established to prevent these conditions, but none have yet succeeded. Objective: To describe factors which influence overweight and obesity in school-age children five to 11 years old in Mexico, and national strategies for the prevention and management of these conditions. Methods: The data herein is derived from six National Health and Nutrition Surveys in Mexico: 2006, 2012, 2016, 2018, 2020, and 2021. They include a total of 45,216 school-age children with complete anthropometric data (weight/height) distributed over 84 pseudo-panels defined by age, wellbeing condition class (WCC), gender, and type of locality of residence. The indicators calculated were overweight and obesity by body mass index according to World Health Organization guidelines. Predictors are food consumption indicators in five groups. Results: The prevalence of overweight and obesity showed a positive linear trend (p < 0.001), with average annual increases of 0.41%. Increases in fruit consumption reduced the prevalence of these conditions by 6.6% (p = 0.01) and vegetable consumption reduced this by 8.3%. Conclusions: Overweight and obesity in school-age children is a growing problem with serious repercussions for future life. New strategies are needed which focus on involving food systems, which translates to healthy and sustainable diets.

Co-learning during the co-creation of a dengue early warning system for the health sector in Barbados.

Over the past decade, the Caribbean region has been challenged by compound climate and health hazards, including tropical storms, extreme heat and droughts and overlapping epidemics of mosquito-borne diseases, including dengue, chikungunya and Zika. Early warning systems (EWS) are a key climate change adaptation strategy for the health sector. An EWS can integrate climate information in forecasting models to predict the risk of disease outbreaks several weeks or months in advance. In this article, we share our experiences of co-learning during the process of co-creating a dengue EWS for the health sector in Barbados, and we discuss barriers to implementation as well as key opportunities. This process has involved bringing together health and climate practitioners with transdisciplinary researchers to jointly identify needs and priorities, assess available data, co-create an early warning tool, gather feedback via national and regional consultations and conduct trainings. Implementation is ongoing and our team continues to be committed to a long-term process of collaboration. Developing strong partnerships, particularly between the climate and health sectors in Barbados, has been a critical part of the research and development. In many countries, the national climate and health sectors have not worked together in a sustained or formal manner. This collaborative process has purposefully pushed us out of our comfort zone, challenging us to venture beyond our institutional and disciplinary silos. Through the co-creation of the EWS, we anticipate that the Barbados health system will be better able to mainstream climate information into decision-making processes using tailored tools, such as epidemic forecast reports, risk maps and climate-health bulletins, ultimately increasing the resilience of the health system.

Sexual Behaviors and HIV/STI Prevention Strategies Among Sexual Minority Men in Ecuador Who Use Geosocial Networking Apps.

Around the world, geosocial networking apps have become widely popular among sexual minority men (SMM). This research analyzed the sexual behaviors and HIV and STI prevention strategies (HIV/STI testing, HIV/STI inquiry, and HIV/STI disclosure) of an online-recruited sample of 284 SMM living in Ecuador. Sexting and oral sex were the most common sexual behaviors among SMM in the sample. Most participants had low perceptions of HIV and STI risk; 85% reported being tested for HIV and 70% for STIs. Being older predicted higher odds of being tested for either HIV or STIs at least once. Being single also predicted HIV testing. Future interventions in the country should explore apps' utility as intervention tools to spread information about sexual health and HIV prevention strategies, such as condom use and event-driven PrEP. Apps can also facilitate connections to sexual health services, including programs for PrEP initiation and linkage to HIV treatment. They should also focus on promoting sexual harm reduction conversations among potential app-met sexual partners.

Early Life Microbial Exposure and Immunity Training Effects on Asthma Development and Progression.

Asthma is the most common inflammatory disease affecting the lungs, which can be caused by intrauterine or postnatal insults depending on the exposure to environmental factors. During early life, the exposure to different risk factors can influence the microbiome leading to undesired changes to the immune system. The modulations of the immunity, caused by dysbiosis during development, can increase the susceptibility to allergic diseases. On the other hand, immune training approaches during pregnancy can prevent allergic inflammatory diseases of the airways. In this review, we focus on evidence of risk factors in early life that can alter the development of lung immunity associated with dysbiosis, that leads to asthma and affect childhood and adult life. Furthermore, we discuss new ideas for potential prevention strategies that can be applied during pregnancy and postnatal period.

Preventing Vector-Borne Transmission of Zika Virus Infection During Pregnancy, Puerto Rico, USA, 2016-20171.

We examined pregnant women's use of personal protective measures to prevent mosquito bites during the 2016-2017 Zika outbreak in Puerto Rico. Healthcare provider counseling on recommended measures was associated with increased use of insect repellent among pregnant women but not with wearing protective clothing.

Long-term change in the prevalence of intimate partner violence: a 20-year follow-up study in León, Nicaragua, 1995-2016.

Introduction: Although intimate partner violence (IPV) affects an estimated one out of three women globally, evidence on violence prevention is still scarce. No studies have measured long-term change in larger populations over a prolonged period. Methods: The aim of this study was to measure changes in the prevalence of IPV in León, Nicaragua, between 1995 and 2016. The 2016 study interviewed 846 ever-partnered women aged 15 to 49 regarding experiences of physical, sexual and emotional IPV. These findings were analysed together with comparable data collected from 354 women in 1995. Multivariate logistic regression modelling was carried out on a pooled data set to identify differences between the two studies while controlling for potential confounding factors. Results: Lifetime physical IPV decreased from 54.8 to 27.6 per cent (adjusted OR (AOR) 0.37; 95% CI 0.28 to 0.49) and 12-month prevalence of physical IPV decreased from 28.2 to 8.3 per cent (AOR 0.29; 95% CI 0.20 to 0.42), respectively. Similar decreases were found in lifetime and 12-month emotional IPV. No significant difference was found in the prevalence of lifetime sexual violence between the two time periods. Conclusions: The results suggest that the reduction in IPV was not due to demographic shifts, such as increased education or age, but reflects a true decrease in the prevalence of IPV. The decrease is not likely to have occurred on its own, and may be attributable to multisectoral efforts by the Nicaraguan government, international donors and the Nicaraguan women's movement to increase women's knowledge of their rights, as well as access to justice and services for survivors during this time period.

The promise and pitfalls of social science research in an emergency: lessons from studying the Zika epidemic in Brazil, 2015-2016.

Social science generates evidence necessary to control epidemics. It can help to craft appropriate public health responses, develop solutions to the epidemic impacts and improve understanding of why the epidemic occurred. Yet, there are practical constraints in undertaking this international research in a way that produces quality, ethical and appropriate data, and that values all voices and experiences, especially those of local researchers and research participants. In this paper, we reflected on the experience of undertaking social science research during the 2015/2016 Zika epidemic in Brazil. This experience was considered from the perspective of this paper's authors: three Brazilian academics, two UK academics and two mothers of children affected by congenital Zika syndrome. This group came together through the conduct of the Social and Economic Impact of Zika study, a mixed-methods social science study. The key findings highlight practical issues in the achievement of three goals: the conduct of high-quality social science in emergencies and efforts towards the decolonisation of global health in terms of levelling the power between Brazilian and UK researchers and optimising the role of patients within research. From our perspective, the information collected through social science was valuable, providing detailed insight into the programmatic needs of mothers and their affected children (eg, economic and social support and mental health services). Social science was considered a low priority within the Zika epidemic despite its potential importance. There were logistical challenges in conducting social science research, foremost of which are the difficulties in developing a trusting and balanced power relationship between the UK and Brazilian researchers in a short time frame. When these issues were overcome, each partner brought unique qualities, making the research stronger. The mothers of affected children expressed dissatisfaction with research, as they were involved in many studies which were not coordinated, and from which they did not see a benefit. In conclusion, the importance of social science in epidemics must continue to be promoted by funders. Funders can also set in place mechanisms to help equalise the power dynamics between foreign and local researchers, researchers and participants, both to promote justice and to create best quality data.

Estrategias de participación en la prevención comunitaria para el control de la Leptospirosis humana / Participation strategies in community prevention for human leptospirosis control

Introducción: Las estrategias de prevención comunitaria resultan básicas para alcanzar logros en salud y en especial en las tasas de mortalidad infantil, así como en las de morbilidad y mortalidad por enfermedades transmisibles. Objetivo: Sistematizar los resultados de investigaciones sobre estrategias de prevención de la leptospirosis a través de la participación comunitaria. Métodos: Se realizó una revisión documental, investigación cualitativa y descriptiva, se emplearon métodos teóricos: el histórico-lógico, analítico-sintético, inductivo-deductivo. Conclusiones: La sistematización de la bibliografía especializada y las investigaciones realizadas sobre la temática de las estrategias de prevención para la leptospirosis humana con carácter integral participativo ha puesto de manifiesto suficientes elementos de juicio para efectuar apreciaciones en función de planear una estrategia educativa con fines preventivos fundamentada en las mejores experiencias de Cuba y del resto del mundo(AU)

Introduction: Community prevention strategies are basic to achieve positive health outcome, especially in infant mortality rates, as well as regarding morbidity and mortality for due to communicable diseases. Objective: To systematize research outcome on leptospirosis prevention strategies through community involvement. Methods: A documentary review was carried out, for a qualitative and descriptive research, theoretical methods were used: the historical-logical, the analytical-synthetic, and the inductive-deductive. Conclusions: The systematization of the specialized bibliography and the research carried out on the topic of human leptospirosis prevention strategies with a participatory holistic character has revealed enough elements of judgment to make appraisals in order to plan an educational strategy with preventive purposes based on the best experiences of Cuba and the rest of the world(AU)

Does expanding primary healthcare improve hospital efficiency? Evidence from a panel analysis of avoidable hospitalisations in 5506 municipalities in Brazil, 2000-2014.

BACKGROUND: Hospitals account for the major share of health expenditure. Primary healthcare may improve efficiency at the hospital level by reducing avoidable admissions. We examined whether rapid expansion of primary healthcare in the context of Brazil's Family Health Strategy (FHS) was associated with a reduction in avoidable hospitalisations. METHODS: We constructed panel data for 5506 municipalities over 2000-2014. Our primary outcome was the rate of avoidable hospitalisations, defined with reference to the official list of ambulatory care sensitive conditions (ACSC). The exposure variable was FHS coverage. We used first-difference models at the municipality level, controlling for municipality characteristics and confounding trends. We ran similar models for each of the 19 diseases in the list of ACSCs. FINDINGS: FHS coverage expanded from 14% to 64% of the population between 2000 and 2014. Over the same period, the rate of avoidable hospitalisations fell from 17 to 10 per 1000 population. Results from the econometric analysis show that the FHS at full coverage was associated with an increase of 0.6 (95% CI 0.3 to 0.9; p<0.001) in the rate of avoidable hospital admissions. Expansion of the FHS was associated with an increase of 866 (95% CI 762 to 970; p<0.001) in the rate of primary care consultations. The FHS was not significantly associated with a reduction in hospitalisations for any of the 19 conditions. CONCLUSIONS: While high-quality primary healthcare can deliver considerable health benefits to the population, it may not always be effective in addressing inefficiencies at the hospital level due to avoidable admissions.

Quimioprevención del cáncer de mama / Chemoprevention in breast cancer

El conocimiento actual del mecanismo de carcinogénesis ha impulsado el estudio de diferentes fármacos que podrían influir en el desarrollo del cáncer de mama. Se ha observado beneficio con la inhibición de la actividad estrogénica sobre el tejido mamario en pacientes con riesgo aumentado. Esto constituye una estrategia de prevención primaria, por lo que se ha denominado quimioprevención. La categorización del riesgo se basa en el análisis de factores de riesgo, el estudio de síndromes de cánceres hereditarios y la presencia de lesiones proliferativas con atipía de la mama. Existen modelos matemáticos para estimar el riesgo, pero todavía no han sido validados en nuestra población. Los fármacos aprobados para quimioprevención son dos serms: el tamoxifeno y el raloxifeno. En cuanto a los Inhibidores de la Aromatasa, si bien han demostrado beneficio, aún no han sido aprobados. Lo que se recomienda es establecer medidas de quimioprevención en pacientes con score de alto riesgo según índices matemáticos (en aquellas poblaciones en que han sido validados), en pacientes con lesiones proliferativas con atipía (Carcinoma lobulillar in situ, Hiperplasia ductal atípica, Hiperplasia lobulillar atípica). Hasta la actualidad, existe controversia en cuanto a su empleo en pacientes con antecedentes de cánceres hereditarios, debido a la alta frecuencia de receptores negativos que presentan estos tumores. A pesar de dichas recomendaciones, la indicación y adherencia a la quimioprevención continua siendo baja.

Current knowledge of the mechanism of carcinogenesis has launched the study of different drugs that could influence the development of breast cancer. Benefit has been observed with the inhibition of estrogenic activity on tissue in high risk patients. This constitutes a strategy of primary prevention; so it has been denominated chemoprevention. Risk categorization is based on the analysis of risk factors, the study of risk syndromes hereditary cancers and the presence of proliferative lesions with breast atypia. There are mathematical models for estimating risk, but they have not been yet validated in our population. Approved drugs for chemoprevention are serms: tamoxifen and raloxifene. Although the benefit of Aromatase Inhibitors have been demonstrated, so far they have not been approved. Therefore it is recommended to establish chemoprevention in patients with high risk score according to mathematical indexes (in population that has been validated), in patients with proliferative lesions with atypia (Lobular carcinoma in situ, Atypical ductal hyperplasia, Lobular hyperplasia atypical). Still remains controversy in patients with hereditary cancer, due to the high frequency of negative receptors that present these tumors. Despite of these recommendations, the indication and adherence to chemoprevention continues being low.

Prevention of intestinal parasites in a tri-border area of Latin America: Children perceptions and an integral health education strategy.

To investigate knowledge of school-aged children and their perception on intestinal parasites, and to assess knowledge reconstruction on prevention practices after specific training in the subject. We performed an activity package that included the analysis of children's drawings of intestinal parasites, and information and communication technologies (ITCs) to transfer knowledge about these pathogens and prevention measures. Retrieval learning activities were performed to fixation of general and specific prevention and control measures.Overall, we found that there is a knowledge gap in many aspects of parasite biology and ecology, and therefore on the risk of infection and acquisition mechanisms. After ITCs, the children improved their knowledge over non-trained children.The approaches used to transfer knowledge and for learning, fixation were valuable tools for incorporating changes in misconceptions and in the deep-rooted habits that favour entero-parasitic diseases. This has important implications for the specific design of future education materials and campaigns. Understanding of perceptions helps to provide justifications and knowledge to achieve changes in unhealthy habits, and it constitutes the basis for the transformation of many risky practices.

Contribuições e limites do uso da abordagem centrada na pessoa para a fundamentação teórica do aconselhamento em DST/Aids / Contributions and limits of the use of person-centered therapy (pct) for the theoretical foundation of STD/Aids Counseling / Aportaciones y límites del uso de la abordaje centrada en la persona (acp) para la fundamentación teórica de la consejería en VIH/SIDA

Mesmo sendo uma importante tecnologia de prevenção, estudos nacionais e internacionais indicam que o aconselhamento no campo das DST/aids, apresenta fragilidades e problemas, entre eles, a carência de fundamentação teórica ou inconsistências entre bases teóricas e desdobramentos técnicos. Este estudo pretendeu examinar as contribuições conceituais de um dos quadros teóricos que infl uenciaram a construção de estratégias e técnicas de aconselhamento em DST no Brasil, a Abordagem Centrada na Pessoa (ACP), de Carl Rogers, assim como as limitações de seu uso no âmbito das DST/aids, a partir da análise de documentos produzidos pela Organização Mundial de Saúde, Programa de Aids das Nações Unidas (UNAIDS), e Ministério da Saúde - Brasil, tidos como as principais referências normativas para o aconselhamento. Tratou-se o material documental de forma interpretativa, cotejando-se as construções conceituais rogerianas com os componentes do processo de trabalho recomendado nos documentos, examinando-se sua consistência e coerência internas. Evidenciaram-se incompatibilidades em relação aos objetivos, foco, resultados esperados e postura do profissional. Tais desacordos parecem decorrer de diferenças entre as finalidades originais do aconselhamento baseado na ACP e aquelas demandadas nas estratégias de prevenção às DST/aids. A confluência de diversas finalidades colocadas ao aconselhamento no campo das DST/aids, configuram obstáculos a um uso consistente da ACP. Conclui-se pela pertinência e interesse da abordagem rogeriana no aconselhamento como técnica de apoio para tomada de decisões e manejo de situações cotidianas no campo da prevenção, mas aponta-se a necessidade de rever objetivos e procedimentos padronizados voltados à mudança de comportamento e a vigilância epidemiológica.

Although it figures as an important prevention technology, national and international studies point out that counseling in the STD/AIDS field present frailties and problems, among them the lack of theoretical grounds or inconsistencies among theoretical bases and technical developments. This study aimed to examine the conceptual contribution of one of the theoretical frames that influenced the construction of counseling strategies and techniques in STD in Brazil, the Person-centered therapy (PCT), developed by Carl Rogers, as well as the limits of its employment in the STD/AIDS context, from the analysis of documents produced by the World Health Organization, the Joint United Nations Program on HIV/AIDS (UNAIDS), and Ministry of Health - Brazil, regarded as the main normative references for counseling. The documentary material was approached interpretively, the rogerian conceptual constructions compared with the work process recommended in the documents, examining its consistence and internal coherence. Incompatibilities were evidenced regarding their objectives, focus, expected results and professional attitude. Such disagreements seem to stem from differences among the original aims of PCT-based counseling and those demanded in STD/AIDS prevention strategies. The confl uence of many goals added to counseling in the field of STD/AIDS presented complications to a consistent use of the PCT. The study agrees with the pertinence and interest of the rogerian approach in counseling as a support technique for the decision making and management of everyday situations in the field of prevention, but the need to revise objectives and standardized procedures focused on behavioral change and epidemiological vigilance is also stressed.

Estudios nacionales e internacionales indican que a consejería en ETS/sida presenta fragilidades y problemas tales como la carencia de fundamentación teórica o inconsistencias entre bases teóricas y desdoblamientos técnicos. Este estudio examinó contribuciones de uno de los marcos teóricos que influyeron en la construcción de estrategias de consejería en ETS en Brasil, el Abordaje Centrado en la Persona (ACP), de Carl Rogers. Se analizaron las limitaciones de su uso en el ámbito de las ETS/sida, a partir del análisis de documentos producidos por la Organización Mundial de la Salud, el Programa de Sida de Naciones Unidas y el Ministerio de Salud de Brasil. El material documental fue tratado desde el punto de vista interpretativo, cotejando las construcciones conceptuales rogerianas con los componentes del proceso de trabajo recomendado en los documentos, examinándose la consistencia y coherencia internas. Fueron evidenciadas incompatibilidades en relación a: objetivos, foco, resultados esperados y postura del profesional. Tales desacuerdos parecen ser consecuencia de diferencias entre las finalidades originales de la consejería basada en la ACP y aquellas requeridas en las estrategias de prevención de ETS/sida. La confluencia de diversas finalidades confiadas a la consejería en el campo de las ETS/sida configura obstáculos para un uso consciente de la ACP. Se señala la pertinencia del abordaje rogeriano en la consejería como técnica de apoyo en la toma de decisiones y el manejo de situaciones cotidianas, pero se apunta a la necesidad de rever objetivos y procedimientos estandarizados y orientados al cambio de comportamiento y a la vigilancia epidemiológica.

Realidad Virtual y Psicoeducación: Formatos de Prevención Selectiva en Trastornos de la Conducta Alimentaria / Virtual Reality and Psychoeducation: Selective Prevention Formats in Eating Disorders

La prevención de los trastornos alimentarios es considerada por los psicólogos de la salud como una tarea prioritaria a cubrir. De acuerdo con esta idea se propuso analizar y evaluar la eficacia de dos programas de intervención basados en distintas estrategias. La muestra no probabilística estuvo formada por 58 estudiantes, con edad promedio de 13.43, (DE=1.14). Las participantes se asignaron al azar a dos distintos programas de prevención selectiva: Psicoeducación (n=28; x̅ de edad=13.46, DE=1.17) y Realidad Virtual Reforzada (n=30; x̅ de edad=13.40, DE=1.13). Los resultados muestran que no se detectaron diferencias entre los programas. Al evaluar el efecto de los dos programas por separado (prestest-postest) se obtuvieron resultados positivos y estadísticamente significativos (p < .001) en variables asociadas con imagen corporal y conductas alimentarias de riesgo. Además se observó una disminución importante en el porcentaje de participantes que se ubicaban en riesgo (significancia clínica) como producto de los programas. Estos hallazgos son alentadores debido a la importancia implicada en la disminución de factores de riesgo y el efecto que tiene en la salud de las adolescentes.

The prevention of eating disorders is considered, mainly by psychologists of health, a priority task to cover. In accord to this idea it was decided to analyze and evaluate the effectiveness of two intervention programs based in different strategies. The nonrandom sample consisted of n=58 students with a mean age of x̅ =13.43 (SD=1.14), which were randomly assigned to two different selective prevention programs: Psychoeducation (n = 28; age of x̅ =13.46, SD=1.17) and Virtual reality Reinforced (n=30; age of x̅ =13.40, SD=1.13). The results showed no differences between programs. However, when each was evaluated (pretest / postest) results were positive and statistically significant (p < .001) in those variables associated with body image and disordered eating. In addition there was a significant decrease in the percentage of participants who were placed at risk (clinical significance) as a result of the preventive programs. These findings are encouraging because of the importance involved in reducing risk factors and the effect it has on the health of adolescents.

Control of ochratoxin A production in grapes.

Ochratoxin A (OTA) is a mycotoxin commonly present in cereals, grapes, coffee, spices, and cocoa. Even though the main objective of the food and feed chain processors and distributors is to avoid the extended contamination of plant-derived foods and animal feeds with mycotoxins, until now, complete OTA removal from foods and feedstuffs is not feasible. Prevention through pre-harvest management is the best method for controlling mycotoxin contamination. However, in the case that the contamination occurs after this stage, the hazards associated with OTA must be managed through post-harvest strategies. Due to the increasing number of fungal strains resistant to chemical fungicides and the impact of these pesticides on the environment and human health, maximum levels of chemical residues have been regulated in many products. Alternative methods are necessary to substitute or complement treatments with fungicides to control fungi under field or storage conditions. Yeasts are considered one of the most potent biocontrol agents due to their biology and non-toxic properties. Epiphytic yeasts are the major component of the microbial community on the surface of grape berries and they are evolutionarily adapted to this ecological niche. Nowadays, several yeast species included in different genera are considered as potential biocontrol agents to control both, growth of ochratoxigenic Aspergillus species and OTA accumulation.

Programa contra el acoso escolar en Finlandia: un instrumento de prevención que valora el respeto y la dignidad / The anti- bullying school program in Finland: a prevention instrument that values respect and dignity

En este artículo se describe el caso de éxito del programa desarrollado por la Universidad de Turku contra el acoso escolar (bullying) desarrollado por los investigadores de dicha institución para las escuelas públicas en Finlandia. El proyecto que tiene por objeto prevenir y controlar el acoso escolar se puso a prueba por primera vez en 200 escuelas de voluntarios en 2007 y 2008 y se incorporó oficialmente por el Consejo Nacional Finlandés de Educación en 2009. Dirigido por los profesores Cristina Salmivalli y Elisa Poskiparta, el programa está dirigido al personal de toda la escuela, las familias, los estudiantes y las comunidades locales, como un instrumento educativo que ensalza el respeto y la dignidad. Teniendo en cuenta que fomentar buenas prácticas es de gran valor en la educación, este caso de estudio llevado a cabo en Lohja, Finlandia, en octubre de 2010, pretende convertirse en un instrumento inspirador para especialistas que tengan el propósito de crear y llevar a la práctica y de manera efectiva programas para frenar el acoso escolar en las escuelas Brasileñas.(AU)

This article describes a successful University of Turku anti-bullying program designed by the institution's scientific researchers for primary schools in Finland. The project which aims at preventing and controlling bullying in schools was first piloted in 200 volunteer schools in 2007 and 2008 and officially adopted by the Finninsh National Board of Education in 2009. Led by Professors Christina Salmivalli and Elisa Poskiparta, the program is intended to the whole school staff, families , students and the local communities as an educational instrument that values respect and dignity.Taking into consideration that a responsible educator is supposed to be open to learn with other people's successful experiences, this field study that took place in Lohja, Finland in October 2010, has the purpose of becoming an inspiring instrument for specialists to produce and implement effective anti- bullying programs in Brazilian schools.(AU)