Adaptación y validación al español del cuestionario SMP-T2D para evaluar la autogestión de la hipertensión arterial más diabetes tipo 2: PAG-DT2+HTA / Adaptation and validation of the SMP-T2D questionnaire in Spanish for evaluating self-management of high blood pressure and type 2 diabetes: PAG-DT2+HTA

Antecedentes: Entre las condiciones crónicas a nivel mundial, la hipertensión arterial se presenta en uno de cada 3 adultos>40 años, mientras que uno de cada 10 adultos padece de diabetes de tipo 2. Para ambas enfermedades la adherencia al tratamiento farmacológico es>30% y la autogestión, que considera además la dieta y la actividad física, es desconocida porque ningún instrumento permite medirla. El objetivo del siguiente trabajo fue adaptar y validar el instrumento SMP-T2D en español, en pacientes con hipertensión arterial y diabetes de tipo 2. Métodos: Se hizo un proceso de adaptación del cuestionario SMP-T2D mediante la traducción al español, para ser utilizado en pacientes con hipertensión arterial más diabetes de tipo 2. Se realizó la validación convergente y discriminante. Se incluyó a pacientes mayores de 50 años con hipertensión arterial y a pacientes con hipertensión arterial más diabetes de tipo 2. Se eliminó a aquellas personas con cuestionario incompleto o sin consentimiento informado. Resultados: El PAG-DT2 + HTA fue aplicado a 145 pacientes; de ellos, el 54,4% tenían solo hipertensión y el 43,6% hipertensión arterial más diabetes de tipo 2. La edad promedio fue de 66,14 años (DE = 10,78), con una proporción de mujeres del 34,7% y de hombres del 65,3%. La consistencia interna por α de Cronbach del cuestionario fue 0,561 (p = 0,000). La correlación del PAG-DT2+HTA y Morisky-Green fue significativa (p < 0,05). Interesantemente, las personas con mayor educación y mayor remuneración económica alcanzaron una mejor gestión (validez de discriminación). Conclusión: El SMP-T2D que mide la autogestión en pacientes con diabetes de tipo 2, modificado y adaptado al español (PAG-DT2+HTA), también puede medirla en personas con diabetes de tipo 2 + hipertensión arterial

Background: High blood pressure is one of the most common chronic conditions worldwide. It affects one in every 3 adults over 40, while one in 10 suffers from diabetes. For both diseases, adherence to pharmacological treatment is over 30%, and self-management, which takes into account diet and physical activity, is still unknown, as there is no tool available to measure self-management. Therefore, the object of this study was to adapt and validate the Spanish version of the self-management profile for type 2 diabetes (SMP-T2D) questionnaire in patients with type 2 diabetes and high blood pressure among users of first level care in the social security institution of Mexico. Methods: The SMP-T2D was adapted to Spanish by translation into Spanish, and being used only in patients with high blood pressure and type 2 diabetes-hypertension. A convergent and discriminatory validation was performed. Patients over 50 years old with high blood pressure were include. Those that did not complete the questionnaire or give informed consent were rejected. Results: The Spanish version of the SMP-T2D was called PAG-DT2+HTA, and was applied to 145 people with hypertension: 54.4% with hypertension only, and 43.6% with hypertension and type 2 diabetes. Mean age was 66.14 years (SD = 10.78), with 34.7% women and 65.3% men. Internal consistency by α-Cronbach for the questionnaire was 0.561 (P = .000). The correlation between the PAG-DT2+HTA and Morisky-Green was significant. The ability to discriminate between people with and without education and with and without economic means was obtained. Conclusion: The Spanish version of SMP-T2D (PAG-DT2+HTA) that measures self-management in type 2 diabetes, can be used to measure self-management in people with type 2 diabetes-hypertension

[Adaptation and validation of the SMP-T2D questionnaire in Spanish for evaluating self-management of high blood pressure and type 2 diabetes: PAG-DT2+HTA]. / Adaptación y validación al español del cuestionario SMP-T2D para evaluar la autogestión de la hipertensión arterial más diabetes tipo 2: PAG-DT2+HTA.

BACKGROUND: High blood pressure is one of the most common chronic conditions worldwide. It affects one in every 3 adults over 40, while one in 10 suffers from diabetes. For both diseases, adherence to pharmacological treatment is over 30%, and self-management, which takes into account diet and physical activity, is still unknown, as there is no tool available to measure self-management. Therefore, the object of this study was to adapt and validate the Spanish version of the self-management profile for type 2 diabetes (SMP-T2D) questionnaire in patients with type 2 diabetes and high blood pressure among users of first level care in the social security institution of Mexico. METHODS: The SMP-T2D was adapted to Spanish by translation into Spanish, and being used only in patients with high blood pressure and type 2 diabetes-hypertension. A convergent and discriminatory validation was performed. Patients over 50 years old with high blood pressure were include. Those that did not complete the questionnaire or give informed consent were rejected. RESULTS: The Spanish version of the SMP-T2D was called PAG-DT2+HTA, and was applied to 145 people with hypertension: 54.4% with hypertension only, and 43.6% with hypertension and type 2 diabetes. Mean age was 66.14 years (SD=10.78), with 34.7% women and 65.3% men. Internal consistency by α-Cronbach for the questionnaire was 0.561 (P=.000). The correlation between the PAG-DT2+HTA and Morisky-Green was significant. The ability to discriminate between people with and without education and with and without economic means was obtained. CONCLUSION: The Spanish version of SMP-T2D (PAG-DT2+HTA) that measures self-management in type 2 diabetes, can be used to measure self-management in people with type 2 diabetes-hypertension.

Temporal matching among diurnal photosynthetic patterns within the crown of the evergreen sclerophyll Olea europaea L.

Trees are modular organisms that adjust their within-crown morphology and physiology in response to within-crown light gradients. However, whether within-plant variation represents a strategy for optimizing light absorption has not been formally tested. We investigated the arrangement of the photosynthetic surface throughout one day and its effects on the photosynthetic process, at the most exposed and most sheltered crown layers of a wild olive tree (Olea europaea L.). Similar measurements were made for cuttings taken from this individual and grown in a greenhouse at contrasted irradiance-levels (100 and 20% full sunlight). Diurnal variations in light interception, carbon fixation and carbohydrate accumulation in sun leaves were negatively correlated with those in shade leaves under field conditions when light intensity was not limiting. Despite genetic identity, these complementary patterns were not found in plants grown in the greenhouse. The temporal disparity among crown positions derived from specialization of the photosynthetic behaviour at different functional and spatial scales: architectural structure (crown level) and carbon budget (leaf level). Our results suggest that the profitability of producing a new module may not only respond to construction costs or light availability, but also rely on its spatio-temporal integration within the productive processes at the whole-crown level.

Evaluación de la actividad hipotensora del Maytenus krukovii (chuchuhuasi) en rata conciente / Maytenus krukovii (chuchuhuasi) effects on blood pressure and cardiac frequency in conscious rats

Maytenus krukovii (chuchuhuasi), oriunda de la amazonía sudamericana, tradicionalmente se le atribuye acción analgesica, antiinflamatoria, afrodisíaca entre otros; investigaciones reportan acción analgésica con intermediación de receptores opiáceos, efecto antipirético, antiinflamatorio y gastroprotector. El presente estudio experimental indagó acerca de la acción sobre la presión arterial y frecuencia cardiaca del chuchuhasi en rata conciente. Se utilizaron 10 ratas albinas machos, a las que se les administró vía oral, 1000 mg/kg de extracto metanolico de chuchuhuasi, se registraron básales y controles de presión arterial y frecuencia cardiaca a las 1, 3, 4 y 24 horas, utilizando el LE 5000 Meter Pressure. Los resultados obtenidos muestran comparados con los valores basáles, actividad hipotensora del Maytenus Krukovii destacándose el máximo efecto a la hora de administración arterial sistólica (238 vs. 181 mmhg), diastolica (200 vs 129 nmhg) y media (299 vs 187 mmhg); respecto a la frecuencia cardiaca Maytenus Krukovii mostró actividad bradicárdica, siendo su máximo efecto a las 3 horas de administrar el chuchuhuasi (430 vs 386 latidos por minutos). Se concluye en que Maytenus krukovii presenta acción hipotensora y cronotropa negativa.

Maytenus krukovii (chuchuhuasi), is originary from the South America Amazonian Forest, traditionally anti-inflammatory, analgesic, aphrodisiac proporties are atributed to this plant. Research reports suggest analgesic action by intermediation of opioid receptors, antipyretic effect, antiinflammatory and gastro protective actions. The presente experimental study inquited about the action of chuchuhuasi on blood pressure and cardiac frequency on conscious rats. Ten male albino rats were administered orally with 1000 mg/kg of methanolic extract of chuchuhuasi. Basal blood pressure and cardiac frequency were registared alt hour 1, 3, 4 and 24, using LE 5000 Meter Pressure. Results obtained show comparative values regarding basal values, with hipontensive activity of Maytenus krukovii. The maximum values is detected at the first hour of administration, systolic blood pressure (238 vs. 181 mmHg), diastolic (200 vs. 129 NMHG) and media (299 vs. 187 mmHg); were obtained. Redarding cardiac frequency, Maytenus krukowii showed bradychardic activity the highest effect recorded after 3 hours (430 vs. 386 beats/minute). We conclude that Maytenus krukovii has hypotensive action and negative chronotropic effects.

Developing school mental health in a rural state. The New Mexico School Mental Health Initiative.

Enhancing the effectiveness of intervention in addressing barriers to development and learning requires collaboration among agencies, schools, families, and communities. Inadequate policy support related to any of these matters decreases the likelihood of enhancing intervention effectiveness on a large scale.