Encuesta Nacional de Salud y Nutrición 2023: metodología y avances de la Ensanut Continua 2020-2024.

OBJETIVO: Presentar la metodología de la Encuesta Nacional de Salud y Nutrición 2023 (Ensanut 2023) y describir los procedimientos de inferencia para conjuntar la información colectada por la Ensanut Continua 2020-2024. Material y métodos. La Ensanut 2023 es la cuarta encuesta de la serie Ensanut Continua. Se describe el alcance de la Ensanut 2023 junto con sus procedimientos de muestreo, estimación, medición y organización logística. Además, se discute el procedimiento básico de estimación para analizar la integración de las encuestas Ensanut Continua 2020-2024. RESULTADOS: La Ensanut 2023 obtendrá a nivel nacional al menos 11 720 entrevistas completas de hogar y 13 378 cuestionarios completos de adulto. La unión de las Ensanut Continua 2020-2023 permitirá, en general, estimar a nivel estatal prevalencias p≥5% en adultos, con confiabilidad tolerable según las recomendaciones del Instituto Nacional de Estadística y Geografía. CONCLUSIONES: El análisis de la unión de la Ensanut Continua 2020-2023 permitirá iniciar la generación de estimaciones nacionales y estatales sobre el estado de salud y nutrición de la población mexicana.

Economic impacts associated with the health effects of climate change in South America: a scoping review.

This scoping review assesses the current evidence on the health impacts of climate change and associated economic costs in South America. In total, 3281 studies were identified using a systematic search strategy, but only 23 articles met the inclusion criteria and were analysed. The results from these articles indicate that the health effects of climate change will likely be costly for South America; however, evidence is limited to a handful of countries or regional analyses that ignore heterogeneity across and within countries. Most of the analysed studies looking at extreme weather events related to climate change focus on the effects and costs of droughts and fire events. A broader understanding of the topic could be achieved by estimating other extreme weather events' health effects and costs, using appropriate research methods to identify causal impacts, and including a more comprehensive and representative regional population sample. Beyond identifying effects, it is important to investigate demand responses for healthcare services, associated costs, availability and expansion of infrastructure, and cost-effectiveness of policies aimed at coping with and adapting to the health dimension of climate change.

Metodología de la Encuesta Nacional de Salud y Nutrición 2022 y Planeación y diseño de la Ensanut Continua 2020-2024.

OBJETIVO: Presentar el diseño de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2022 y cuantificar el avance de la Ensanut Continua 2020-2024. Material y métodos. La Ensanut 2022 es la tercera encuesta de la serie de en-cuestas denominada Ensanut Continua 2020-2024. En este documento se describe el alcance de la Ensanut 2022 y sus procedimientos de muestreo, medición y organización logís-tica. Además, se presenta el avance esperado de la Ensanut Continua 2020-2024 al concluir la Ensanut 2022. Resulta-dos. La Ensanut 2022 obtendrá, a nivel nacional, al menos 10 160 entrevistas completas de hogar y 9 441 resultados de seropositividad a SARS-CoV-2. CONCLUSIONES: La Ensanut 2022 estimará la prevalencia de seropositividad a SARS-CoV-2 a nivel nacional y regional y avanzará en la acumulación de información para alcanzar los objetivos de la Ensanut Con-tinua 2020-2024.

Estrategias y herramientas de capacitación en seguridad y salud en el trabajo, en el sector construcción / Strategies and Tools for Occupational Health and Safety Training in the Construction Sector / Estratégias e ferramentas para treinamento em segurança e saúde ocupacional no setor de construção

Introducción: En los últimos años, el sector de la construcción en Colombia se ha ubicado en el cuarto lugar entre los sectores económicos con mayor accidentalidad. Las cifras indican que de los 1233 accidentes laborales en el país, 156 pertenecían a este sector. La capacitación en seguridad y salud en el trabajo desempeña un papel funda-mental para reducir los índices de accidentalidad. Objetivo: Mencionar algunas estrategias y herramientas digitales actualizadas para la capacitación en seguridad y salud en el trabajo en el sector de la construcción. Método: Revisión teórico-descriptiva de tipo documental. Algunas bases de datos consultadas fueron: Medline, ScienceDirect, Scopus, SciELO, Proquest y Pubmed. Como criterio de selección se incluyeron artículos en inglés y español a partir del 2015 y algunos anteriores como referentes históricos. De más de 80 trabajos consultados, 53 cumplieron con los criterios de inclusión; además, se validó cada descriptor en ciencias de la salud (Decs). Conclusiones: Existen diferentes estrategias y herramientas que podrían usarse para la capacitación en riesgos laborales, que van desde las actividades lúdicas, pasando por herramientas digitales, hasta estrategias de participación activa del trabajador que permitan una mayor concientización y apropiación del conocimiento en materia de seguridad, que incentiven la aplicación de prácticas seguras, teniendo en cuenta su contexto crítico de accidentalidad

Introduction: In recent years, the construction sector in Colombia, has ranked fourth among the economic sectors with the highest accident rates in the country, figures indicate that of the 1233 occupational accidents in Colombia, 156 belong to the construction sector. Occupational health and safety training plays a fundamental role in reducing accident rates. Objective: To mention some updated strategies and digital tools for training in occupational safety and health in the construction sector. Method: Theoretical and descriptive documentary review. Some databases consulted were Medline, ScienceDirect, Scopus, SciELO, Proquest and Pubmed. As a selection criterion, articles in English and Spanish from 2015 and some previous ones were included as historical references. Of more than 60 papers consulted, 53 met the inclusion criteria, in addition, each Descriptor in Health Sciences (DeCS) was validated. Conclusions: There are different strategies and tools that could be used for training in occupational hazards, ranging from playful activities, digital tools and strategies of active worker participation that allow greater awareness and appropriation of knowledge on safety, encouraging the application of safe practices taking into account their critical context of accident rate.

Introdução: Nos últimos anos, o setor de construção na Colômbia ocupou o quarto lugar entre os setores econômicos com maior índice de acidentes. Os números indicam que dos 1233 acidentes de trabalho ocorridos no país, 156 ocorreram neste setor. O treinamento em segurança e saúde ocupa-cional tem um papel fundamental na redução das taxas de acidentes. Objetivo: Mencionar algumas estratégias e ferramentas digitais atualizadas para o treinamento em segurança e saúde ocupacional no setor de construção. Método: Revisão teórico-descritiva de tipo documental. Alguns bancos de dados consultados foram: Medline, ScienceDirect, Scopus, SciELO, Proquest e Pubmed. Os critérios de seleção incluíram artigos em inglês e espanhol a partir de 2015 e alguns artigos anteriores como referentes históricas. Dos mais de 80 artigos consultados, 53 preenchiam os critérios de inclusão; além disso, foi validada cada pala-vra-chave nos descritores em ciências da saúde (Decs). Conclusões: Existem diferentes estratégias e ferramentas que poderiam ser utilizadas para o treina-mento sobre riscos ocupacionais, desde atividades lúdicas, passando por ferramentas digitais, até es-tratégias de participação ativa dos trabalhadores que permitem maior conscientização e apropriação de conhecimentos sobre segurança, que incentivam a aplicação de práticas seguras, levando em conta seu contexto critico de acidentes

Metodología de la Encuesta Nacional de Salud y Nutrición 2021 / National Health and Nutrition Survey 2021 methodology

Resumen: Objetivo: Describir el diseño de la Encuesta Nacional de Salud y Nutrición 2021 (Ensanut 2021). Material y métodos: La Ensanut 2021 es una encuesta probabilística de hogares que forma parte de la serie de Ensanut Continua 2020-2024. En esta ocasión se describen el alcance, el muestreo, la medición y la organización logística. Resultados: Se planea obtener al menos 12 060 entrevistas de hogar completas a nivel nacional y 9 837 muestras para determinar seropositividad a SARS-CoV-2 a nivel nacional. Conclusiones: La Ensanut 2021 permitirá realizar inferencias regionales sobre la prevalencia de seropositividad a SARS-CoV-2 y también acumular información para realizar inferencias estatales en el año 2024.

Abstract: Objective: To describe the design of the Mexican 2021 National Health and Nutrition Survey (Ensanut 2021). Materials and methods: The Ensanut 2021 is a probabilistic household survey that is part of the continuous Ensanut 2020-2024; survey outreach, sampling, measurement and logistic organization are described. Results: It is planned to obtain at least 12 060 complete household interviews and 9 837 samples to determine SARS-CoV-2 seropositivity at the national level. Conclusions: Ensanut 2021 will allow to estimate the seroprevalence of SARS-CoV-2 antibodies at regional and national level; also, it will accumulate information to make state inferences for the year 2024.

Pancreatitis necrotizante por áscaris lumbricoides: causas, diagnóstico y tratamiento actual / Necrotizing pancreatitis due to Ascaris lumbricoides: Causes, diagnosis, and current treatment

Resumen La necrosis en la pancreatitis aguda muestra una mortalidad muy alta a pesar de los avances en cuidados críticos. Después de la etiología biliar y alcohólica, la tercera causa más común de pancreatitis es la idiopática, con un 10 % de los casos secundarios a parásitos, y el áscaris es el parásito más común implicado en la necrosis e inflamación del páncreas. Teniendo en cuenta la alta mortalidad que representa la pancreatitis necrotizante, se describe un reporte de caso por ascariasis, destacando su creciente epidemiología, sus causas, su diagnóstico clínico e imagenológico, y su tratamiento antiparasitario según la evidencia actual.

Abstract Necrosis in acute pancreatitis presents a high mortality rate despite advances in critical care. After biliary and alcoholic etiology, the third most common cause of pancreatitis is idiopathic etiology, with 10% of cases related to parasites, being Ascaris the most common parasite involved in pancreas necrosis and inflammation. Considering the high rates of mortality related to necrotizing pancreatitis, a case of ascariasis is analyzed, including its growing epidemiology, its causes, its clinical and imaging diagnosis, and its antiparasitic treatment based on current evidence.

Molecular Epidemiology of Multidrug-Resistant Uropathogenic Escherichia coli O25b Strains Associated with Complicated Urinary Tract Infection in Children.

BACKGROUND: Uropathogenic Escherichia coli (UPEC) has increased the incidence of urinary tract infection (UTI). It is the cause of more than 80% of community-acquired cystitis cases and more than 70% of uncomplicated acute pyelonephritis cases. AIM: The present study describes the molecular epidemiology of UPEC O25b clinical strains based on their resistance profiles, virulence genes, and genetic diversity. METHODS: Resistance profiles were identified using the Kirby-Bauer method, including the phenotypic production of extended-spectrum ß-lactamases (ESBLs) and metallo-ß-lactamases (MBLs). The UPEC serogroups, phylogenetic groups, virulence genes, and integrons were determined via multiplex PCR. Genetic diversity was established using pulsed-field gel electrophoresis (PFGE), and sequence type (ST) was determined via multilocus sequence typing (MLST). RESULTS: UPEC strains (n = 126) from hospitalized children with complicated UTIs (cUTIs) were identified as O25b, of which 41.27% were multidrug resistant (MDR) and 15.87% were extensively drug resistant (XDR). The O25b strains harbored the fimH (95.23%), csgA (91.26%), papGII (80.95%), chuA (95.23%), iutD (88.09%), satA (84.92%), and intl1 (47.61%) genes. Moreover, 64.28% were producers of ESBLs and had high genetic diversity. ST131 (63.63%) was associated primarily with phylogenetic group B2, and ST69 (100%) was associated primarily with phylogenetic group D. CONCLUSION: UPEC O25b/ST131 harbors a wide genetic diversity of virulence and resistance genes, which contribute to cUTIs in pediatrics.

Prenatal indole-3-carbinol administration activates aryl hydrocarbon receptor-responsive genes and attenuates lung injury in a bronchopulmonary dysplasia model.

Hyperoxia-hypoxia exposure is a proposed cause of alveolar developmental arrest in bronchopulmonary dysplasia in preterm infants, where mitochondrial reactive oxygen species and oxidative stress vulnerability are increased. The aryl hydrocarbon receptor (AhR) is one of the main activators of the antioxidant enzyme system that protects tissues and systems from damage. The present study aimed to determine if the activation of the AhR signaling pathway by prenatal administration of indole-3-carbinol (I3C) protects rat pups from hyperoxia-hypoxia-induced lung injury. To assess the activation of protein-encoding genes related to the AhR signaling pathway (Cyp1a1, Cyp1b1, Ugt1a6, Nqo1, and Gsta1), pup lungs were excised at 0, 24, and 72 h after birth, and mRNA expression levels were quantified by reverse transcription-quantitative polymerase chain reaction assays (RT-qPCR). An adapted Ratner's method was used in rats to evaluate radial alveolar counts (RACs) and the degree of fibrosis. The results reveal that the relative expression of AhR-related genes in rat pups of prenatally I3C-treated dams was significantly different from that of untreated dams. The RAC was significantly lower in the hyperoxia-hypoxia group (4.0 ± 1.0) than that in the unexposed control group (8.0 ± 2.0; P < 0.01). When rat pups of prenatally I3C-treated dams were exposed to hyperoxia-hypoxia, an RAC recovery was observed, and the fibrosis index was similar to that of the unexposed control group. A cytokine antibody array revealed an increase in the NF-κB signaling cascade in I3C-treated pups, suggesting that the pathway could regulate the inflammatory process under the stimulus of this compound. In conclusion, the present study demonstrates that I3C prenatal treatment activates AhR-responsive genes in pup's lungs and hence attenuates lung damage caused by hyperoxia-hypoxia exposure in newborns.

Metodología de la Encuesta Nacional de Salud y Nutrición 2021.

Objetivo. Describir el diseño de la Encuesta Nacional de Salud y Nutrición 2021 (Ensanut 2021). Material y métodos. La Ensanut 2021 es una encuesta probabilística de hogares que forma parte de la serie de Ensanut Continua 2020-2024. En esta ocasión se describen el alcance, el muestreo, la medición y la organización logística. Resultados. Se planea obtener al menos 12 060 entrevistas de hogar completas a nivel nacional y 9 837 muestras para determinar seropositividad a SARS-CoV-2 a nivel nacional. Conclusiones. La Ensanut 2021 permitirá realizar inferencias regionales sobre la prevalencia de seropositividad a SARS-CoV-2 y también acumular información para realizar inferencias estatales en el año 2024.

The Mexican Cognitive Aging Ancillary Study (Mex-Cog): Study Design and Methods.

OBJECTIVE: Describe the protocol sample and instruments of the Cognitive Aging Ancillary Study in Mexico (Mex-Cog). The study performs an in-depth cognitive assessment in a subsample of older adults of the ongoing Mexican Health and Aging Study (MHAS). The Mex-Cog is part of the Harmonized Cognitive Assessment Protocol (HCAP) design to facilitate cross-national comparisons of the prevalence and trends of dementia in aging populations around the world, funded by the National Institute on Aging (NIA). METHODS: The study protocol consists of a cognitive assessment instrument for the target subject and an informant questionnaire. All cognitive measures were selected and adapted by a team of experts from different ongoing studies following criteria to warrant reliable and comparable cognitive instruments. The informant questionnaire is from the 10/66 Dementia Study in Mexico. RESULTS: A total of 2,265 subjects aged 55-104 years participated, representing a 70% response rate. Validity analyses showed the adequacy of the content validity, proper quality-control procedures that sustained data integrity, high reliability, and internal structure. CONCLUSIONS: The Mex-Cog study provides in-depth cognitive data that enhances the study of cognitive aging in two ways. First, linking to MHAS longitudinal data on cognition, health, genetics, biomarkers, economic resources, health care, family arrangements, and psychosocial factors expands the scope of information on cognitive impairment and dementia among Mexican adults. Second, harmonization with other similar studies around the globe promotes cross-national studies on cognition with comparable data. Mex-Cog data is publicly available at no cost to researchers.

[Indigenous condition in health services: comparison of quality of care 2012-2018 for poor population.] / La condición indígena en los servicios de salud: comparación de la calidad en la atención 2012-2018 para la población en pobreza.

OBJECTIVE: To compare the perception of the quality of ambulatory care in users of health services in 2012 and 2018, by indigenous and non-indigenous condition. MATERIALS AND METHODS: With information from two population surveys (Encuesta Nacional de Salud y Nutrición [Ensanut] 2012 and Ensanut 100k) the quality of care was analyzed based on indicators of structure, process, health outcome and care satisfaction. RESULTS: Between 2012 and 2018, the use of private health services increased; favorable opinion about the conditions of the site, and perception of short waiting times decreased among non-indigenous people. In public health services, the supply of medicines remained high, the laboratory and Rx tests in the same care unit and pharma- cology treatment explanation decreased, particularly among non-indigenous patients. Perception of health improvement and satisfaction of care was adequate. CONCLUSIONS: An ambulatory care model aimed to response needs and expectations of the most vulnerable population, mainly the indigenous population, is a priority.

OBJETIVO: Comparar la percepción de la calidad de atención ambulatoria de servicios de salud en 2012 y 2018, por condición indígena y no indígena. MATERIAL Y MÉTODOS: Con información de dos encuestas poblacionales (Encuesta Nacional de Salud y Nutrición [Ensanut] 2012 y Ensanut 100k) se analizó la calidad de atención con indicadores de estructura, proceso, resultado en salud y satisfacción. RESULTADOS: Entre 2012 y 2018 aumentó la utilización de servicios privados, disminuyó la buena opinión sobre las condiciones del lugar y la percepción de tiempo de espera corto para utilizadores no indígenas. Para servicios públicos se mantuvo alto el surtimiento de medicamentos, disminuyó la realización de estudios de laboratorio y gabinete en la unidad de atención y la explicación del tratamiento farmacológico principalmente en no indígenas. La percepción de mejoría y la satisfacción fue buena. CONCLUSIONES: Es prioritario un modelo de atención ambulatoria acorde con las necesidades y expectativas de la población más vulnerable y, principalmente, indígena.

[Medical care and self-care actions in people living with diabetes, according to socioeconomic level.] / Atención médica y acciones de autocuidado en personas que viven con diabetes, según nivel socioeconómico.

OBJECTIVE: To characterize medical care and self-care actions in a population with diabetes in locations smaller than 100 000 inhabitants. MATERIALS AND METHODS: With information from the Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), two logistic regression models were obtained: not performing five basic actions in the last consultation and not taking priority self-care actions. RESULTS: Having low schooling, belonging to the low economic stratum, and speaking indigenous language, increase the probability of not taking self-care actions. On the contrary, as age increases, the chances of self-care are reduced by 3%. Belonging to an indigenous household and the low tercile, increases the chances that health personnel will not perform the five basic actions during the consultation. CONCLUSIONS: It is essential that a diabetes control program be established that includes patient education and update courses for medical staff.

OBJETIVO: Caracterizar la atención médica y las acciones de autocuidado en población con diabetes, en localidades de menos de 100 000 habitantes. MATERIAL Y MÉTODOS: Con información de la Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), se obtuvieron dos modelos de regresión logística: no realizar las cinco acciones básicas en la última consulta médica y no realizar acciones prioritarias de autocuidado. RESULTADOS: Tener baja escolaridad, pertenecer al estrato económico bajo y hablar lengua indígena incrementan las posibilidades de no realizar acciones de autocuidado. Por el contrario, al incrementarse la edad, se disminuyen las posibilida- des de autocuidado en 3%. Pertenecer a un hogar indígena y al tercil bajo incrementan las posibilidades de que el personal de salud no realice las cinco acciones básicas durante la consulta. CONCLUSIONES: Es indispensable que se establezca un programa de control de diabetes que incluya educación a pacientes y cursos de actualización al personal médico.

La condición indígena en los servicios de salud: comparación de la calidad en la atención 2012-2018 para la población en pobreza / Indigenous condition in health services: comparison of quality of care 2012-2018 for poor population

Resumen: Objetivo: Comparar la percepción de la calidad de atención ambulatoria de servicios de salud en 2012 y 2018, por condición indígena y no indígena. Material y métodos. Con información de dos encuestas poblacionales (Encuesta Nacional de Salud y Nutrición [Ensanut] 2012 y Ensanut 100k) se analizó la calidad de atención con indicadores de estructura, proceso, resultado en salud y satisfacción. Resultados: Entre 2012 y 2018 aumentó la utilización de servicios privados, disminuyó la buena opinión sobre las condiciones del lugar y la percepción de tiempo de espera corto para utilizadores no indígenas. Para servicios públicos se mantuvo alto el surtimiento de medicamentos, disminuyó la realización de estudios de laboratorio y gabinete en la unidad de atención y la explicación del tratamiento farmacológico principalmente en no indígenas. La percepción de mejoría y la satisfacción fue buena. Conclusión: Es prioritario un modelo de atención ambulatoria acorde con las necesidades y expectativas de la población más vulnerable y, principalmente, indígena.

Abstract: Objective: To compare the perception of the quality of ambulatory care in users of health services in 2012 and 2018, by indigenous and non-indigenous condition. Materials and methods: With information from two population surveys (Encuesta Nacional de Salud y Nutrición [Ensanut] 2012 and Ensanut 100k) the quality of care was analyzed based on indicators of structure, process, health outcome and care satisfaction. Results: Between 2012 and 2018, the use of private health services increased; favorable opinion about the conditions of the site, and perception of short waiting times decreased among non-indigenous people. In public health services, the supply of medicines remained high, the laboratory and Rx tests in the same care unit and pharmacology treatment explanation decreased, particularly among non-indigenous patients. Perception of health improvement and satisfaction of care was adequate. Conclusion: An ambulatory care model aimed to response needs and expectations of the most vulnerable population, mainly the indigenous population, is a priority.

Atención médica y acciones de autocuidado en personas que viven con diabetes, según nivel socioeconómico / Medical care and self-care actions in people living with diabetes, according to socioeconomic level

Resumen: Objetivo: Caracterizar la atención médica y las acciones de autocuidado en población con diabetes, en localidades de menos de 100 000 habitantes. Material y métodos: Con información de la Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), se obtuvieron dos modelos de regresión logística: no realizar las cinco acciones básicas en la última consulta médica y no realizar acciones prioritarias de autocuidado. Resultados: Tener baja escolaridad, pertenecer al estrato económico bajo y hablar lengua indígena incrementan las posibilidades de no realizar acciones de autocuidado. Por el contrario, al incrementarse la edad, se disminuyen las posibilidades de autocuidado en 3%. Pertenecer a un hogar indígena y al tercil bajo incrementan las posibilidades de que el personal de salud no realice las cinco acciones básicas durante la consulta. Conclusión: Es indispensable que se establezca un programa de control de diabetes que incluya educación a pacientes y cursos de actualización al personal médico.

Abstract: Objective: To characterize medical care and self-care actions in a population with diabetes in locations smaller than 100 000 inhabitants Materials and methods: With information from the Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), two logistic regression models were obtained: not performing five basic actions in the last consultation and not taking priority self-care actions. Results: Having low schooling, belonging to the low economic stratum, and speaking indigenous language, increase the probability of not taking self-care actions. On the contrary, as age increases, the chances of self-care are reduced by 3%. Belonging to an indigenous household and the low tercile, increases the chances that health personnel will not perform the five basic actions during the consultation. Conclusions: It is essential that a diabetes control program be established that includes patient education and update courses for medical staff

[Methodology of the National Health and Nutrition Survey for localities with less than 100 000 inhabitants (Ensanut 100k)]. / Metodología de la Encuesta Nacional de Salud y Nutrición para localidades con menos de 100 000 habitantes (Ensanut 100k).

OBJECTIVE: To describe the methodological design of the National Health and Nutrition Survey in localities with less than 100 000 inhabitants (Ensanut 100k). MATERIALS AND METHODS: The Ensanut 100k is a probabilistic survey that over-represents households with less economic capabilities. This paper describes the scope of the survey, sampling procedures, measurement and inference and logistics organization. RESULTS: 10 461 home interviews and 26 161 individual interviews were obtained. The household response rate was 89 and 92% from individuals. CONCLUSIONS: The probabilistic design of the Ensanut 100k allows to make valid statistical inferences about parameters of interest for public health in localities with less than 100 000 inhabitants, localities where 52% of the population lives according to the 2010 census. The comparability of the results with the Ensanut 2012 faci- litates the assessment of the government's support actions to populations with lower economic capacities in the period 2012-2018.

OBJETIVO: Describir el diseño metodológico de la Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k). MATERIAL Y MÉTODOS: La Ensanut 100k es una encuesta probabilística que sobrerrepresenta a los hogares con menos capacidades económicas. Se describe el alcance de la encuesta, los procedimientos de muestreo, medición e inferencia y la organización logística. RESULTADOS: Se obtuvieron 10 461 entrevistas de hogar y 26 161 de individuos. La tasa de respuesta de hogar fue 89% y de individuos 92. CONCLUSIONES: El diseño probabilístico de la Ensanut 100k permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública en localidades con menos de 100 000 habitantes, localidades donde vive 52% de la población según el censo de 2010. La comparabilidad de los resultados con la Ensanut 2012 facilita evaluar las acciones de apoyo que otorga el gobierno a poblaciones con menores capacidades económicas en el periodo 2012-2018.

Metodología de la Encuesta Nacional de Salud y Nutrición para localidades con menos de 100 000 habitantes (Ensanut 100k) / Methodology of the National Health and Nutrition Survey for localities with less than 100 000 inhabitants (Ensanut 100k)

Resumen: Objetivo: Describir el diseño metodológico de la Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k). Material y métodos: La Ensanut 100k es una encuesta probabilística que sobrerrepresenta a los hogares con menos capacidades económicas. Se describe el alcance de la encuesta, los procedimientos de muestreo, medición e inferencia y la organización logística. Resultados: Se obtuvieron 10 461 entrevistas de hogar y 26 161 de individuos. La tasa de respuesta de hogar fue 89% y de individuos 92%. Conclusiones: El diseño probabilístico de la Ensanut 100k permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública en localidades con menos de 100 000 habitantes, localidades donde vive 52% de la población según el censo de 2010. La comparabilidad de los resultados con la Ensanut 2012 facilita evaluar las acciones de apoyo que otorga el gobierno a poblaciones con menores capacidades económicas en el periodo 2012-2018.

Abstract: Objective: To describe the methodological design of the National Health and Nutrition Survey in localities with less than 100 000 inhabitants (Ensanut 100k). Materials and methods: The Ensanut 100k is a probabilistic survey that over-represents households with less economic capabilities. This paper describes the scope of the survey, sampling procedures, measurement and inference and logistics organization. Results: 10 461 home interviews and 26 161 individual interviews were obtained. The household response rate was 89 and 92% from individuals. Conclusions: The probabilistic design of the Ensanut 100k allows to make valid statistical inferences about parameters of interest for public health in localities with less than 100 000 inhabitants, localities where 52% of the population lives according to the 2010 census. The comparability of the results with the Ensanut 2012 facilitates the assessment of the government's support actions to populations with lower economic capacities in the period 2012-2018.

Non-gait-specific intervention for the rehabilitation of walking after SCI: role of the arms.

Arm movements modulate leg activity and improve gait efficiency; however, current rehabilitation interventions focus on improving walking through gait-specific training and do not actively involve the arms. The goal of this project was to assess the effect of a rehabilitation strategy involving simultaneous arm and leg cycling on improving walking after incomplete spinal cord injury (iSCI). We investigated the effect of 1) non-gait-specific training and 2) active arm involvement during training on changes in over ground walking capacity. Participants with iSCI were assigned to simultaneous arm-leg cycling (A&L) or legs only cycling (Leg) training paradigms, and cycling movements were assisted with electrical stimulation. Overground walking speed significantly increased by 0.092 ± 0.022 m/s in the Leg group and 0.27 ± 0.072m/s in the A&L group after training. Whereas the increases in the Leg group were similar to those seen after current locomotor training strategies, increases in the A&L group were significantly larger than those in the Leg group. Walking distance also significantly increased by 32.12 ± 8.74 m in the Leg and 91.58 ± 36.24 m in the A&L group. Muscle strength, sensation, and balance improved in both groups; however, the A&L group had significant improvements in most gait measures and had more regulated joint kinematics and muscle activity after training compared with the Leg group. We conclude that electrical stimulation-assisted cycling training can produce significant improvements in walking after SCI. Furthermore, active arm involvement during training can produce greater improvements in walking performance. This strategy may also be effective in people with other neural disorders or diseases. NEW & NOTEWORTHY This work challenges concepts of task-specific training for the rehabilitation of walking and encourages coordinated training of the arms and legs after spinal cord injury. Cycling of the legs produced significant improvements in walking that were similar in magnitude to those reported with gait-specific training. Moreover, active engagement of the arms simultaneously with the legs generated nearly double the improvements obtained by leg training only. The cervico-lumbar networks are critical for the improvement of walking.

Socioeconomic Status and Longitudinal Lung Function of Healthy Mexican Children.

INTRODUCTION: Our aim was to estimate the longitudinal effect of Socioeconomic status (SES) on lung function growth of Mexican children and adolescents. MATERIALS AND METHODS: A cohort of Mexican children in third grade of primary school was followed with spirometry twice a year for 6 years through secondary school. Multilevel mixed-effects lineal models were fitted for the spirometric variables of 2,641 respiratory-healthy Mexican children. Monthly family income (in 2002 U.S. dollars [USD]) and parents' years completed at school were used as proxies of SES. RESULTS: Individuals with higher SES tended to have greater height for age, and smaller sitting height/standing height and crude lung function. For each 1-year increase of parents' schooling, Forced expiratory volume in 1 sec (FEV1) and Forced vital capacity (FVC) increased 8.5 (0.4%) and 10.6 mL (0.4%), respectively (p <0.05) when models were adjusted for gender. Impact of education on lung function was reduced drastically or abolished on adjusting by anthropometric variables and ozone. CONCLUSIONS: Higher parental schooling and higher monthly family income were associated with higher lung function in healthy Mexican children, with the majority of the effect likely due to the increase in height-for-age.

Progression of aging in Mexico: the Mexican Health and Aging Study (MHAS) 2012.

OBJECTIVE: To describe the third wave of the Mexican Health and Aging Study (MHAS), completed in 2012, and present preliminary results. MATERIALS AND METHODS: Descriptive analyses by gender and age group of demographic and socioeconomic characteristics, health conditions and health behaviors, as well as social support and life satisfaction measures are presented. In addition, external validations are presented by comparing MHAS 2012 indicators with other national data sources. RESULTS: For the panel of older adults in the sample, the rate of health care insurance coverage increased greatly between 2001 and 2012, a significantly higher change in rural compared to urban areas. The results for 2012 are consistent with the previous two waves for the main indicators of health and physical disability prevalence, risk factors,and behaviors. CONCLUSIONS: The MHAS offers a unique opportunity to study aging in Mexico, as well as to complete cross-national comparisons. The cumulative number of deaths in the cohort should support the study of mortality and its association with health outcomes and behaviors over the life cycle. In addition, the sub-samples of objective markers will enable methodological research on self-reports and associations of biomarkers in old age with similar health outcomes and behaviors.

Efectos a largo plazo de los síntomas depresivos en una tarea de memoria de trabajo con y sin interferencia atencional / Long-term effects of depressive symptoms on a task of visual working memory with and without attentional interference

La neurobiología de la depresión involucra cambios estructurales del sistema nervioso relacionados con procesos cognitivos como la memoria y la atención. El objetivo del presente estudio fue evaluar el efecto a largo plazo de la sintomatología depresiva (SD) en una tarea de memoria de trabajo visual con y sin interferencia atencional en estudiantes universitarios. Se utilizó un diseño factorial de 2 X 2 en el cual las variables independientes fueron la condición clínica (con SD y sin SD) y la versión del Memonum (con o sin interferencia de color). Memonum es un software para evaluar memoria de trabajo por medio de la retención de dígitos directos, en dos versiones: una blanco-negro (sin interferencia) y otra con un distractor atencional de color (con interferencia). Para la evaluación de la SD, 76 universitarios respondieron al CES-D, luego se les aplicó aleatoriamente una u otra versión de la prueba Memonum (con o sin interferencia de color), 2 semanas después de la detección de síntomas. De manera general, la SD no alteró a largo plazo el desempeño de los participantes en tareas de memoria de trabajo visual con o sin interferencia atencional. Sin embargo, se pudo establecer que la utilización de las estrategias para la ejecución de la tarea mnemónica dependió de la condición clínica, y la agrupación fue la menos usada por los participantes con SD.

The neurobiology of depression involves structural changes in the nervous system associated with cognitive processes such as memory and attention. This study sought to evaluate the long-term effect of depressive symptomatology (DS) using a task of visual working memory with or without attentional interference in college students. A 2 X 2 factorial design was used wherein the independent variables were the clinical condition (with and without DS) and the Memonum version (with and without interference of color). The Memonum consists of software to evaluate working memory through retention of direct digits, in two versions: a black-white (without interference) and another with a color attentional distractor (with interference). Depressive symptomatology was evaluated by applying the CES-D to 76 undergraduates. Two week after the diagnosis of DS, the test version was randomly applied (with or without attentional interference). The DS did not alter long-term performance of the tasks involved in visual working memory with or without attentional interference. However, it was found that the use of strategies for mnemonic task performance depended on the clinical condition, being the strategy of grouping the least used by the participants with DS.