The power of us: breaking barriers and bridging the gap of ultrasound in rheumatology to empower a new generation.

OBJECTIVE: This study assesses musculoskeletal ultrasound (MSUS) knowledge, attitudes, and practices among young rheumatologists in Mexico, aiming to identify barriers and facilitators to its clinical use. METHODS: An online survey distributed to a network of young rheumatologists captured demographics, institutional, and personal MSUS information. Multivariable analysis identified factors associated with positive MSUS attitudes. RESULTS: Ninety-six rheumatologists (39.18% national response rate) completed the survey. Of respondents (54.2% females, median age 35.1 years), 81.2% deemed MSUS necessary in clinical rheumatology. The main barriers included limited training access (56.2%) and required training time (54.1%). Lack of scientific evidence was not a major barrier (60.4%). Positive MSUS attitudes were associated with learning from conferences (p = 0.029) and colleagues (p = 0.005), formal (p = 0.043), and in-person training (p = 0.020), MSUS use in practice (p = 0.027), and use by radiologists in their institute (p < 0.001). Interest in learning MSUS (88.5%) was significantly higher in those with positive attitudes (94.4%, p < 0.001). Elastic net analysis identified key drivers, including learning MSUS from conferences, colleagues, and in residency; using MSUS in practice; respondent-performed MSUS; and MSUS use by radiologists. Statistically significant associations were found with using MSUS for synovitis/inflammatory joint disease (OR = 1.43, 95% CI 1.00-2.05) and MSUS use by radiologists in respondent's institutes (OR = 1.70, 95% CI 1.20-2.90). CONCLUSION: Most young rheumatologists in Mexico recognize the necessity of MSUS in clinical practice. By addressing identified barriers, encouraging rheumatologist-radiologist collaboration, and establishing a regulatory body to certify rheumatologist's MSUS experience, there is an opportunity to empower them with the necessary skills for effective MSUS use, ultimately benefiting patient care.

Reduction of NrF2 as coadjuvant during the development of persistent periapical lesions

Background: Persistent periapical lesions (PPL) are the result of pulpar necrosis induced by bacterial infection resulting in bone degradation and culminating with the loss of dental piece. Pathological changes in the peripapice are associated with the presence of free radicals. The transcription factor Nrf2 is the main regulator of the endogenous antioxidant response against oxidative stress and has been implicated in the regulation of osteoclastogenesis.The aim is to determine the oxidative condition in samples from patients with Persistent Periapical Injuries as a detonating factor of tissue damage. Material and methods: An observational, descriptive, cross-sectional study was carried out in samples with PPL (cases) and samples by removal of third molars (controls) obtained in the clinic of the specialty in endodontics, University of Guadalajara. Samples were submitted to histological staining with Hematoxylin-Eosin, lipoperoxide analysis, Superoxide Dismutase (SOD), Glutathione-Peroxidase (GPx) and Catalase (CAT) activities were determined by immunoenzymatic assays and NrF2 by Western Blot analysis. Results: Samples from PPL patients histologically showed an increased presence of lymphocytes, plasma cells, and eosinophils, as well as a decrease in extracellular matrix proteins and fibroblast cells. There was a rise in lipid peroxidation, GPx and SOD activities, but an important decline (36%) in Catalase activity was observed (p<0.005); finally, NrF2-protein was diminished at 10.41%. All comparisons were between cases vs controls. Conclusions: The alterations in antioxidants endogenous NrF2-controlled are related to osseous destruction in patients with PPL. (AU)

Enseñando a ser madres: la educación de mujer a mujer en la Valencia del primer tercio del siglo XX / Teaching to be mothers: education from women to woman in valencia in the first third of the 20th century

A comienzos del siglo XX, las altas cifras de morbi-mortalidad infantil generaron una preocupación creciente del movimiento Higienista, que articuló una respuesta sanitaria compleja, que combinó, entre otras medidas, la puesta en marcha de nuevas instituciones dedicadas a la puericultura y la utilización de nuevas estrategias como la educación para la salud y la divulgación sanitaria. En este contexto, las madres, consideradas causa y solución del problema, fueron el objetivo de dichas estrategias sanitarias dirigidas a mejorar las prácticas de los cuidados infantiles. Las profesionales femeninas próximas a las madres y a los niños, sobre todo maestras y enfermeras, se convirtieron en agentes de promoción de la salud, involucrando a las mujeres en las mejoras de la salud familiar. En la presente investigación, se presenta el estudio de caso de Valencia, como ejemplo de la emergencia de una acción profesional femenina que, a pesar de su visibilidad limitada, fue clave en la mejora de la salud infantil.(AU)

At the beginning of the 20th century, high infant morbidity and mortality rates generated a growing concern in the hygienist movement, which articulated a complex health response that combined, among other measures, the implementation of new institutions dedicated to child care and the use of new strategies such as health education and health promotion. In this context, mothers, seen as both the cause and the solution to the problem, were the target of such health strategies aimed at improving childcare practices. Female professionals close to mothers and children, especially teachers and nurses, became agents of health promotion, involving women in family health improvements. In this research, the case study of Valencia is presented as an example of the emergence of a female professional action that, despite its limited visibility, was key in the improvement of child health.(AU)

Validation of a Questionnaire of Food Education Content on School Catering Websites in Spain.

The aim of this study was to design and validate a questionnaire on quality and food education on catering company websites. For the validation of the questionnaire, its reliability, feasibility and content validity characteristics were determined. For content validity, a panel of experts was used and the overall and item-wise Content Validity Index (CVI) of the experts' responses was calculated. Reliability was determined by the inter-judge agreement method with the analysis of 30 websites using the intraclass correlation coefficient (ICC) and the Bland and Altman plot. Adequate content validity was verified by obtaining a very high CVI (above 0.80) in the analysis of the expert panel's responses and excellent inter-observer agreement with a very high global ICC (above 0.90) value in the determination of test-retest reliability. The questionnaire is a valid instrument for the evaluation of the quality of school catering websites and their content in food education, as it has good feasibility, high content validity and excellent reliability.

Intra- and Interobserver Agreement during the Assessment of the Different Stages of Root Development Using 4 Radiographic Classifications.

INTRODUCTION: This study analyzed intra- and interobserver agreements during radiographic assessment of the different stages of root development using the dichotomous, Moorrees, Demirjian, and Cvek classifications, as well as the effect of the observer's level of experience on the result. METHODS: Two hundred eighty-five digital periapical radiographs were examined via visual inspection by 3 experienced and 3 nonexperienced observers (n = 6) under strict technological and viewing conditions. After observer calibration, determination of the presence or absence of an open apex and the assignment of a root development stage according to the different subdivisions of the 4 indexes were performed. This evaluation was carried out by each observer in duplicate in the first round (n = 8) and repeated in the second round (n = 8). The 16 examinations performed by each observer (N = 96) were analyzed to determine the percentage of concordance followed by intraobserver, interobserver, and global observer agreement using the kappa coefficient and a weighted kappa. Additionally, to determine the level of concordance between the visual determination of an open or closed apex and the apical foramen width measured in millimeters, a dichotomized kappa coefficient was applied. RESULTS: A good level of global observer agreement was found for the dichotomous, Demirjian, and Cvek classifications. However, a significantly low percentage of total concordance and global observer agreement (6.66% and 0.498, respectively) was obtained using the Moorrees classification, which was more pronounced among nonexperienced observers (0.247). Apical foramen width measurements indicated the presence of 143 roots with an open apex (50.2%) and 142 with a closed apex (49.8%), and the dichotomized kappa coefficient test revealed a good level of agreement during the visual determination of an open or closed apex (range, 0.611-0.636). CONCLUSIONS: The classifications of Cvek and Demirjian provided reliable results when determining the different stages of root development. In contrast, the Moorrees classification provided the lowest agreement values, with a significant negative effect among nonexperienced observers. Finally, the visual estimation of the presence (or absence) of an open apex provided a good level of concordance with the radiographic apical foramen width.

A Multi-Objective Approach for Drug Repurposing in Preeclampsia.

Preeclampsia is a hypertensive disorder that occurs during pregnancy. It is a complex disease with unknown pathogenesis and the leading cause of fetal and maternal mortality during pregnancy. Using all drugs currently under clinical trial for preeclampsia, we extracted all their possible targets from the DrugBank and ChEMBL databases and labeled them as "targets". The proteins labeled as "off-targets" were extracted in the same way but while taking all antihypertensive drugs which are inhibitors of ACE and/or angiotensin receptor antagonist as query molecules. Classification models were obtained for each of the 55 total proteins (45 targets and 10 off-targets) using the TPOT pipeline optimization tool. The average accuracy of the models in predicting the external dataset for targets and off-targets was 0.830 and 0.850, respectively. The combinations of models maximizing their virtual screening performance were explored by combining the desirability function and genetic algorithms. The virtual screening performance metrics for the best model were: the Boltzmann-Enhanced Discrimination of ROC (BEDROC)α=160.9 = 0.258, the Enrichment Factor (EF)1% = 31.55 and the Area Under the Accumulation Curve (AUAC) = 0.831. The most relevant targets for preeclampsia were: AR, VDR, SLC6A2, NOS3 and CHRM4, while ABCG2, ERBB2, CES1 and REN led to the most relevant off-targets. A virtual screening of the DrugBank database identified estradiol, estriol, vitamins E and D, lynestrenol, mifrepristone, simvastatin, ambroxol, and some antibiotics and antiparasitics as drugs with potential application in the treatment of preeclampsia.

A population-based study of preeclampsia and eclampsia in Ecuador: ethnic, geographical and altitudes differences.

BACKGROUND: In Ecuador eclampsia and preeclampsia were identified as the third cause of maternal death. Like other Latin-American countries, Ecuador has human settlements living from 0 to more than 4000 m of altitude and comprising a wide ethnic-diversity across all these altitude changes. These characteristics offer the possibility to study a wide variety of possible risk factors for preeclampsia and eclampsia. METHODS: We conducted a population-based retrospective study of all deliveries in Ecuador from 2015 through 2017. The main variables analyzed were: altitude, ethnic self-identification, geographic location, and maternal age. The data comes from the Ecuadorian National Institute of Statistics and Census (INEC) and the Ecuadorian Ministry of Health. Data information regarding maternal parity and socioeconomic status was not available from official records. Logistic regression analysis was used to study the relationship between preeclampsia and eclampsia with the variable of interest. Geospatial statistical analysis was done to identify statistically significant spatial clusters of preeclampsia and eclampsia cases. RESULTS: The incidence of preeclampsia was estimated between 5.11 (5.05-5.18) and 6.23 (6.16-6.30), and 0.25 (0.23-0.26) for eclampsia. Native American have a lower incidence regarding preeclampsia compared to other ethnic groups. High altitude has a significant odds ratio (OR = 2.31, 1.93-2.78) of preeclampsia. Montubio residing in middle altitude (1500-3500 m) have the highest risk of preeclampsia (OR = 18.13, 9.53-34.50). Afro-Ecuadorians also have an increased risk of preeclampsia associated with altitude (OR = 2.36, 1.78-3.14). Ethnicity was not identified as a risk factor for eclampsia. Early and older maternal age was associated with an increased risk of preeclampsia and eclampsia. Women living more than 20 km from the obstetric unit have an OR = 2.61 (2.32-2.95, p-value< 0.01) and OR = 1.87 (1.82-1.92, p-value< 0.01) of developing eclampsia and preeclampsia respectively. CONCLUSIONS: Preeclampsia is widespread across low and high-altitude areas, while eclampsia is mostly located at lower altitudes. Montubios living at middle or high altitudes represents the ethnic group with a higher risk of preeclampsia. No ethnic effect was identified as a potential risk factor for eclampsia. Moreover, in eclampsia the associated risk of young women seems to be higher than in preeclampsia.

Cultural Adaptation and Evaluation of the Perceived Nutrition Environment Measures Survey to the Mediterranean Spanish Context (NEMS-P-MED).

Individuals' perceptions of their food environments are a mediator between exposure to the environment and people's interaction with it. The Nutrition Environment Measures Surveys (NEMS) are valid and reliable measures to assess food environments. In Spain, there is no adapted instrument to measure the perceived obesogenic environment. This article aims to adapt and evaluate the Perceived Nutrition Environment Measures Survey for a Spanish context (NEMS-P-MED). The Spanish version has 32 questions to measure the perception about availability, accessibility and marketing of 3 types of environment: home, shops and restaurants. We assess feasibility, construct validity and internal consistency reliability through a sample of 95 individuals. The internal consistency was acceptable for most items (Cronbach's alpha coefficients range from 0.6 to 0.9), similar to that of the original scale. The NEMS-P-MED has been shown to be valid and, on certain items reliable, and was useful to assess the population's perceptions of the food environment in the home, restaurants and food stores in a Spanish context. Adapting standardized measurement tools to specific contexts to assess the perceived and observed characteristics of food environments may facilitate the development of effective policy interventions to reduce excess weight.

Efectos de un programa alternativo de promoción de la alimentación saludable en comedor escolar / Effects of an alternative program to promote healthy eating in school canteen

Resumen El objetivo del estudio fue determinar los efectos sobre los hábitos alimentarios de escolares en una intervención educativa alternativa al modelo convencional de promoción de alimentación a un centro con comedor y proyecto de huerto ecológico. Estudio observacional descriptivo de corte transversal y comparativo de 111 niños y niñas entre 9 y 12 años, en el periodo 2013-15. Se comparó un colegio con intervención alternativa con otro que únicamente incluía contenidos propios del currículo de Educación Infantil y Primaria, mediante evaluación de adherencia a la dieta mediterránea del alumnado con cuestionario validado Kidmed. El centro de intervención presentó mayor adherencia a la dieta mediterránea que el centro control. En el centro de intervención el porcentaje de alumnado con dieta óptima (64,52%) fue mayor que los que necesitaban mejorar su dieta (33,87%), mientras que en el centro fue inferior (42,86% y 51,02% respectivamente). Los escolares del centro de intervención presentaron mayor porcentaje de respuestas afirmativas en ítems Kidmed. El programa de promoción de alimentación saludable alternativo del centro de intervención podría ser efectivo para la adquisición de una dieta de mayor adherencia a la dieta mediterránea.

Abstract The objective of this study was to determine the effects on school feeding habits in an educational intervention alternative to the conventional model of feeding promotion to a center with school canteens and ecological garden project. Cross-sectional and comparative descriptive observational study of 111 boys and girls between 9 and 12 years old, in the 2013-15 period. A school with alternative intervention was compared with another one that only included contents of the Infant and Primary Education curriculum, by means of evaluation of adherence to the mediterranean diet of the students with a validated Kidmed questionnaire. The intervention center presented greater adherence to the mediterranean diet than the control center. In the intervention center, the percentage of students with optimal diet (64.52%) was higher than those who needed to improve their diet (33.87%), contrary to what occurs in control center (42.86% and 51.02% respectively). The students of the intervention center presented a higher percentage of affirmative answers in Kidmed test. The program of promotion of healthy alternative food of the intervention center could be effective for the acquisition of a diet of greater adherence to the mediterranean diet.

[Effects of an alternative program to promote healthy eating in school canteen]. / Efectos de un programa alternativo de promoción de la alimentación saludable en comedor escolar.

The objective of this study was to determine the effects on school feeding habits in an educational intervention alternative to the conventional model of feeding promotion to a center with school canteens and ecological garden project. Cross-sectional and comparative descriptive observational study of 111 boys and girls between 9 and 12 years old, in the 2013-15 period. A school with alternative intervention was compared with another one that only included contents of the Infant and Primary Education curriculum, by means of evaluation of adherence to the mediterranean diet of the students with a validated Kidmed questionnaire. The intervention center presented greater adherence to the mediterranean diet than the control center. In the intervention center, the percentage of students with optimal diet (64.52%) was higher than those who needed to improve their diet (33.87%), contrary to what occurs in control center (42.86% and 51.02% respectively). The students of the intervention center presented a higher percentage of affirmative answers in Kidmed test. The program of promotion of healthy alternative food of the intervention center could be effective for the acquisition of a diet of greater adherence to the mediterranean diet.

El objetivo del estudio fue determinar los efectos sobre los hábitos alimentarios de escolares en una intervención educativa alternativa al modelo convencional de promoción de alimentación a un centro con comedor y proyecto de huerto ecológico. Estudio observacional descriptivo de corte transversal y comparativo de 111 niños y niñas entre 9 y 12 años, en el periodo 2013-15. Se comparó un colegio con intervención alternativa con otro que únicamente incluía contenidos propios del currículo de Educación Infantil y Primaria, mediante evaluación de adherencia a la dieta mediterránea del alumnado con cuestionario validado Kidmed. El centro de intervención presentó mayor adherencia a la dieta mediterránea que el centro control. En el centro de intervención el porcentaje de alumnado con dieta óptima (64,52%) fue mayor que los que necesitaban mejorar su dieta (33,87%), mientras que en el centro fue inferior (42,86% y 51,02% respectivamente). Los escolares del centro de intervención presentaron mayor porcentaje de respuestas afirmativas en ítems Kidmed. El programa de promoción de alimentación saludable alternativo del centro de intervención podría ser efectivo para la adquisición de una dieta de mayor adherencia a la dieta mediterránea.

[Nutrition and gastronomy in the region of Valencia]. / Nutrición y gastronomía en la Comunitat Valenciana.

INTRODUCTION: Objectives: to analyze the historical development of the Valencian dietary model, establish the relationship between gastronomy and nutrition and explore the role that reclaiming and adapting culinary and gastronomic traditions could play in the promotion of healthy eating. Methods: literature search and content analysis of studies on the subjects under study. Results: traditional Valencian cuisine is characterized by its variety and diversity at local and regional level; however, the extensive use of vegetables in its dishes and recipes renders it unique and was a crucial aspect of the Valencian population's successful food and nutrition transition in the 1960s. Westernization of the Valencian diet and loss of the heritage of the Mediterranean diet in the late 20th century led to a deterioration in the population's nutritional status and the emergence of problems such as overweight and obesity. Faced with this scenario, the modern cuisine spearheaded by the food sector in the Region of Valencia offers an opportunity to reverse this situation, reclaim the region's gastronomic heritage through dialogue between tradition and innovation and help restore healthier eating habits. Conclusions: the culinary grammar of traditional Valencian gastronomy can improve the population's nutrition by providing a healthy, attractive and tasty diet, besides offering a sustainable alternative for production and consumption through its commitment to regional produce.

INTRODUCCIÓN: Objetivos: analizar la evolución histórica que ha experimentado el modelo alimentario valenciano, la relación que cabe establecer entre gastronomía y nutrición y el papel que pueden jugar la recuperación y la adaptación de las tradiciones culinarias y gastronómicas en la promoción de una alimentación saludable. Metodología: búsqueda bibliográfica de trabajos que se han ocupado de los temas objeto de estudio y análisis de sus contenidos. Resultados: la cocina tradicional valenciana se caracteriza por su heterogeneidad y su diversidad comarcal y local, pero la base vegetal de sus platos y recetas le otorga una idiosincrasia gastronómica propia, que resultó clave para completar, en la década de los sesenta, la transición alimentaria y nutricional de la población valenciana. La occidentalización de los regímenes alimentarios de los valencianos y la pérdida de los referentes patrimoniales de la dieta mediterránea que tuvo lugar en las últimas décadas del siglo xx conllevaron un deterioro de su estado nutricional y la emergencia de problemas como el sobrepeso y la obesidad. Frente a semejante panorama, la actualidad y el protagonismo alcanzando por el sector de la gastronomía en la Comunitat Valenciana puede ofrecer una oportunidad para revertir esta situación y, desde el diálogo entre la tradición y la innovación, poner en valor un patrimonio gastronómico que ayude a recuperar hábitos alimentarios más saludables. Conclusiones: la gramática culinaria de la gastronomía valenciana tradicional puede mejorar la forma de nutrirnos al aportar una alimentación saludable, atractiva y sabrosa, además de ofrecer, por su compromiso con el territorio, una alternativa sostenible de producción y consumo.

Nutrición y gastronomía en la Comunitat Valenciana / Nutrition and gastronomy in the region of Valencia

Objetivos: analizar la evolución histórica que ha experimentado el modelo alimentario valenciano, la relación que cabe establecer entre gastronomía y nutrición y el papel que pueden jugar la recuperación y la adaptación de las tradiciones culinarias y gastronómicas en la promoción de una alimentación saludable. Metodología: búsqueda bibliográfica de trabajos que se han ocupado de los temas objeto de estudio y análisis de sus contenidos. Resultados: la cocina tradicional valenciana se caracteriza por su heterogeneidad y su diversidad comarcal y local, pero la base vegetal de sus platos y recetas le otorga una idiosincrasia gastronómica propia, que resultó clave para completar, en la década de los sesenta, la transición alimentaria y nutricional de la población valenciana. La occidentalización de los regímenes alimentarios de los valencianos y la pérdida de los referentes patrimoniales de la dieta mediterránea que tuvo lugar en las últimas décadas del siglo xx conllevaron un deterioro de su estado nutricional y la emergencia de problemas como el sobrepeso y la obesidad. Frente a semejante panorama, la actualidad y el protagonismo alcanzando por el sector de la gastronomía en la Comunitat Valenciana puede ofrecer una oportunidad para revertir esta situación y, desde el diálogo entre la tradición y la innovación, poner en valor un patrimonio gastronómico que ayude a recuperar hábitos alimentarios más saludables. Conclusiones: la gramática culinaria de la gastronomía valenciana tradicional puede mejorar la forma de nutrirnos al aportar una alimentación saludable, atractiva y sabrosa, además de ofrecer, por su compromiso con el territorio, una alternativa sostenible de producción y consumo

Objectives: to analyze the historical development of the Valencian dietary model, establish the relationship between gastronomy and nutrition and explore the role that reclaiming and adapting culinary and gastronomic traditions could play in the promotion of healthy eating. Methods: literature search and content analysis of studies on the subjects under study. Results: traditional Valencian cuisine is characterized by its variety and diversity at local and regional level; however, the extensive use of vegetables in its dishes and recipes renders it unique and was a crucial aspect of the Valencian population's successful food and nutrition transition in the 1960s. Westernization of the Valencian diet and loss of the heritage of the Mediterranean diet in the late 20th century led to a deterioration in the population's nutritional status and the emergence of problems such as overweight and obesity. Faced with this scenario, the modern cuisine spearheaded by the food sector in the Region of Valencia offers an opportunity to reverse this situation, reclaim the region's gastronomic heritage through dialogue between tradition and innovation and help restore healthier eating habits. Conclusions: the culinary grammar of traditional Valencian gastronomy can improve the population's nutrition by providing a healthy, attractive and tasty diet, besides offering a sustainable alternative for production and consumption through its commitment to regional produce

El recurso didáctico de los huertos y las granjas escolares del Programa Edalnu y sus antecedentes (1958-1972) / The didactic resource of school allotments and farms of the Edalnu Program and its antecedents (1958-1972)

El trabajo analiza el antecedente histórico de los huertos y las granjas escolares que promovió el Servicio de Extensión Agraria en sus actividades formativas y divulgativas en la década de 1950; así como la continuidad que tuvieron como unidades educativas desarrolladas en el Programa de Educación en Alimentación y Nutrición (Edalnu) que se puso en marcha en 1961. Como principales fuentes de estudio se han utilizado el Boletín Informativo de Extensión Agraria, con posterioridad Revista de Extensión Agraria así como las publicaciones y documentos que generó el Programa Edalnu y que estaban relacionados con los huertos y las granjas escolares. La implantación de los huertos y granjas ayudó a fomentar la producción local de alimentos protectores, además de mejorar los hábitos alimentarios a nivel escolar y familiar. La aplicación de la metodología de "aprender haciendo" fomentó tanto el aprendizaje por descubrimiento, como el basado en problemas y el aprendizaje servicio. En línea con la corriente historiográfica del tiempo presente y los usos del pasado, la visión integradora del Programa Edalnu, en el que la escuela, el entorno y la familia estaban interconectados, puede servir de ejemplo para las actuales estrategias de educación en alimentación y nutrición

Here, we analyse the creation of school allotments and farms, promoted by the Agricultural Outreach Service as one of its education and training actions in the 1950s, and their continuing existence as educational units within the Food and Nutrition Education Programme (Spanish acronym: Edalnu) launched in 1961. The main sources used in this study were the Boletín Informativo de Extensión Agraria (agricultural outreach newsletter), subsequently named the Revista de Extensión Agraria (agricultural outreach journal), as well as the publications and documents related to school allotments and farms generated by the Edalnu Programme. The implantation of allotments and farms helped to encourage local production of healthy food, as well as improving eating habits by schools and families. Application of the "learning by doing" methodology fostered discovery learning, problem-solving and service. In respect of the history matters and the uses of the past, the integrative vision of the Edalnu Program, in which the school, the environment and the family were interconnected, can serve as an example for the current education strategies in food and nutrition

Data Collection Instruments for Obesogenic Environments in Adults: A Scoping Review.

The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an overview of the existing evidence and enable comparisons. Through the scoping review method, different databases and webpages were searched between January 1997 and May 2018. Instruments were included if they targeted adults. The documents were categorised as food environment or built environment. In terms of results, 92 instruments were found: 46 instruments measuring the food environment, 42 measuring the built environment, and 4 that characterised both environments. Numerous diverse instruments have been developed to characterise the obesogenic environment, and some of them have been developed based on existing ones; however, most of them have not been validated and there is very little similarity between them, hindering comparison of the results obtained. In addition, most of them were developed and used in the United States and were written in English. In conclusion, there is a need for a robust instrument, improving or combining existing ones, for use within and across countries, and more sophisticated study designs where the environment is contemplated in an interdisciplinary approach.

Malnutrición y desigualdades en la España del desarrollismo: las encuestas rurales de alimentación y nutrición / Malnutrition and inequalities in developmentalist Spain: rural food and nutrition surveys

Introducción: la etapa de la autarquía y los primeros años del desarrollismo fue uno de los periodos de la historia contemporánea de España en el que las desigualdades en materia alimentaria y nutricional se hicieron más evidentes. Objetivos: abordar la malnutrición que afectaba a la población rural (municipios de menos de 2000 habitantes), sus desigualdades territoriales y el retraso que mostraba su transición alimentaria y nutricional. Métodos: se han analizado las encuestas rurales de alimentación y nutrición que llevaron a cabo la Comisaría General de Abastecimientos y Transportes (CAT) y el Programa de Educación en Alimentación y Nutrición (Edalnu) entre 1964 y 1972. Resultados: la población rural mostraba un déficit de proteínas animales, de calcio, de vitamina A y de vitamina B2, justificado por el escaso consumo que realizaba de alimentos protectores. Andalucía y la España interior eran las regiones que mostraban mayores porcentajes de personas que no alcanzaban los requerimientos nutricionales. Dichas carencias, que explicaban la prevalencia de caries, así como de lesiones en la piel, en mucosas y oculares, también estaban detrás del retraso en la talla y el peso. No respondían tanto a la escasez de recursos económicos como a la persistencia de hábitos alimentarios inadecuados. Conclusiones: los resultados, además de mostrar el retraso de la población rural española en términos de transición alimentaria y nutricional, avalan las políticas que buscaban estimular en el ámbito rural el consumo de alimentos protectores y empoderar a la población en materia de alimentación y nutrición

Introduction: the stage of autarky and early years of developmentalism was one of the periods in the contemporary history of Spain when inequalities in food and nutrition became more pronounced. Objectives: to examine malnutrition among the rural population (municipalities with fewer than 2000 inhabitants), including territorial inequalities and the delayed onset of a rural food and nutrition transition. Methods: we analysed the rural food and nutrition surveys carried out by the General Commission for Supplies and Transport (Spanish initials: CAT) and the Food and Nutrition Education Programme (Spanish initials: EDALNU) between 1964 and 1972. Results: the rural population presented a deficit of animal proteins, calcium and vitamins A and B2, due to scant consumption of protective foods. Andalucía and inland Spain were the regions with the highest percentage of people whose diet did not meet nutritional requirements. These deficiencies were not only responsible for the prevalence of caries and skin, mucous membrane and eye lesions, but were also behind delayed growth (height and weight). This was not the result so much of poverty as of the persistence of poor eating habits. Conclusions: besides evidencing the delayed onset of a food and nutritional transition in the Spanish rural population, our findings document policies that sought to encourage the consumption of protective foods in rural areas and empower the population with regard to food and nutrition

[Malnutrition and inequalities in developmentalist Spain: rural food and nutrition surveys]. / Malnutrición y desigualdades en la España del desarrollismo: las encuestas rurales de alimentación y nutrición.

INTRODUCTION: the stage of autarky and early years of developmentalism was one of the periods in the contemporary history of Spain when inequalities in food and nutrition became more pronounced. OBJECTIVES: to examine malnutrition among the rural population (municipalities with fewer than 2000 inhabitants), including territorial inequalities and the delayed onset of a rural food and nutrition transition. METHODS: we analysed the rural food and nutrition surveys carried out by the General Commission for Supplies and Transport (Spanish initials: CAT) and the Food and Nutrition Education Programme (Spanish initials: EDALNU) between 1964 and 1972. RESULTS: the rural population presented a deficit of animal proteins, calcium and vitamins A and B2, due to scant consumption of protective foods. Andalucía and inland Spain were the regions with the highest percentage of people whose diet did not meet nutritional requirements. These deficiencies were not only responsible for the prevalence of caries and skin, mucous membrane and eye lesions, but were also behind delayed growth (height and weight). This was not the result so much of poverty as of the persistence of poor eating habits. CONCLUSIONS: besides evidencing the delayed onset of a food and nutritional transition in the Spanish rural population, our findings document policies that sought to encourage the consumption of protective foods in rural areas and empower the population with regard to food and nutrition.

Introducción: la etapa de la autarquía y los primeros años del desarrollismo fue uno de los periodos de la historia contemporánea de España en el que las desigualdades en materia alimentaria y nutricional se hicieron más evidentes.Objetivos: abordar la malnutrición que afectaba a la población rural (municipios de menos de 2000 habitantes), sus desigualdades territoriales y el retraso que mostraba su transición alimentaria y nutricional.Métodos: se han analizado las encuestas rurales de alimentación y nutrición que llevaron a cabo la Comisaría General de Abastecimientos y Transportes (CAT) y el Programa de Educación en Alimentación y Nutrición (Edalnu) entre 1964 y 1972.Resultados: la población rural mostraba un déficit de proteínas animales, de calcio, de vitamina A y de vitamina B2, justificado por el escaso consumo que realizaba de alimentos protectores. Andalucía y la España interior eran las regiones que mostraban mayores porcentajes de personas que no alcanzaban los requerimientos nutricionales. Dichas carencias, que explicaban la prevalencia de caries, así como de lesiones en la piel, en mucosas y oculares, también estaban detrás del retraso en la talla y el peso. No respondían tanto a la escasez de recursos económicos como a la persistencia de hábitos alimentarios inadecuados.Conclusiones: los resultados, además de mostrar el retraso de la población rural española en términos de transición alimentaria y nutricional, avalan las políticas que buscaban estimular en el ámbito rural el consumo de alimentos protectores y empoderar a la población en materia de alimentación y nutrición.

Enfermería y control social: las actividades socio-sanitarias de la Sección Femenina de Falange en la ciudad de Valencia (1940-1977) / Nursing and social control: the health and welfare activities of the Women’s Section of the Falange in the city of Valencia (1940-1977)

Objetivo: Analizar las actividades de carácter socio-sanitario que llevaron a cabo en la ciudad de Valencia las enfermeras sociales visitadoras y las divulgadoras de la Sección Femenina de Falange. Material y método: Se ha combinado el enfoque cualitativo y cuantitativo. Se realizó una búsqueda bibliográfica de los trabajos relacionados con la historia de la enfermería y la actividad de la Sección Femenina (S.F.) durante el primer franquismo. Como principal fuente documental se han utilizado los legajos depositados en el Archivo del Reino de Valencia (A.R.V), Sección Femenina Inventario (S.F.I.) (1940-1977), referidos a la actividad que llevó cabo dicha organización en la ciudad de Valencia, así como los informes remitidos por las enfermeras a sus Regidoras Locales y por estas a la Regidora Nacional. Resultados: Las actividades desarrolladas tuvieron connotaciones de índole ideológica y política, y estuvieron relacionadas con cuatro parcelas de actuación: el ámbito sanitario, el social, la educación para la salud y cuestiones de índole religiosa. Destaca la importancia que se atribuyó a la lucha contra la mortalidad infantil, dentro del contexto de las políticas pro-natalistas del primer franquismo. La falta de recursos y de incentivos profesionales, junto con la pérdida de influencia política de Sección Femenina, motivó que dichas actividades fueran decreciendo a lo largo del período objeto de estudio. Conclusiones: Los resultados ponen de manifiesto la complejidad de las funciones que tenían asignadas las enfermeras sociales y las divulgadoras de Sección Femenina, al mismo tiempo que muestran la influencia que tenía el contexto sociopolítico e ideológico en el desarrollo de las mismas (AU)

Objective: To analyse the health and welfare activities carried out by social health visitors and rural health advisors of the Women’s Section (in Spanish: Sección Femenina, S.F.) in the city of Valencia. Materials and method: This study combined a qualitative and quantitative approach. A literature search was conducted to identify studies related to the history of nursing and the activities of the Women’s Section during the first stage of the Franco regime. The main source of information consulted was the collection of files deposited in the Archives of the Kingdom of Valencia (Spanish initials: A.R.V), the Inventory of the Women’s Section (Spanish initials: S.F.I.) (1940-1977), concerning the activities carried out by this organisation in the city of Valencia, as well as the reports submitted by nurses to their local directors and by these to the national director. Results: The activities carried out had ideological and political nuances and were related to four areas of action: health, society, health education and religion. Particular importance was given to the fight against infant mortality, within the context of the pro-birth policies of the first stage of the Franco regime. However, these activities declined over the period studied due to a lack of professional resources and incentives, together with the Women’s Section’s loss of political influence. Conclusions: The findings underscore the complexity of the functions assigned to social health visitors and health advisors within the Women’s Section, and also demonstrate the influence exerted by the socio-political and ideological context on the performance of these same functions (AU)

Short chain fatty acids (butyric acid) and intestinal diseases / Ácidos grasos de cadena corta (ácido butírico) y patologías intestinales

INTRODUCTION: Short chain fatty acids contain up to 6 carbon atoms. Among them, butyric acid stands out for its key role in pathologies with intestinal affectation. Butyric acid is the main energetic substrate of the colonocyte, it stimulates the absorption of sodium and water in the colon, and presents trophic action on the intestinal cells. OBJECTIVES: To review the clinical use of formulations for the oral use of butyric acid. METHODS: Review of published articles on oral supplementation with butyric acid in intestinal pathologies. RESULTS: The publications mainly deal with the use of oral butyric acid in pathologies involving inflammation and / or alterations of intestinal motility. Highlighting the clinical potential in inflammatory bowel diseases and irritable bowel syndrome. CONCLUSION: The use of oral supplementation with butyric acid is a promising strategy in pathologies such as inflammatory bowel diseases and irritable bowel syndrome. Bio-available butyric acid formulations with acceptable organoleptic characteristics are being advanced.

INTRODUCCIÓN: los ácidos grasos de cadena corta contienen un máximo de 6 átomos de carbono. Entre ellos, destaca el ácido butírico por su papel clave en las patologías de afectación intestinal. El ácido butírico es el principal sustrato energético del colonocito, estimula la absorción de sodio y agua en el colon, y presenta acción trófica sobre las células intestinales. OBJETIVOS: revisar el uso clínico de formulaciones para uso por vía oral de ácido butírico. MÉTODOS: revisión de artículos publicados sobre suplementación oral con ácido butírico en patologías intestinales. RESULTADOS: las publicaciones tratan principalmente del uso de ácido butírico por vía oral en patologías que cursan con inflamación y/o alteraciones de la motilidad intestinal. Destacando el potencial clínico en enfermedades inflamatorias intestinales y el síndrome de intestino irritable. CONCLUSIÓN: el uso de suplementación oral con ácido butírico es una estrategia prometedora en patologías como las enfermedades inflamatorias intestinales y el síndrome de intestino irritable. Se está avanzando en formulaciones de ácido butírico biodisponibles y de características organolépticas aceptables.

Consensus strategy in genes prioritization and combined bioinformatics analysis for preeclampsia pathogenesis.

BACKGROUND: Preeclampsia is a multifactorial disease with unknown pathogenesis. Even when recent studies explored this disease using several bioinformatics tools, the main objective was not directed to pathogenesis. Additionally, consensus prioritization was proved to be highly efficient in the recognition of genes-disease association. However, not information is available about the consensus ability to early recognize genes directly involved in pathogenesis. Therefore our aim in this study is to apply several theoretical approaches to explore preeclampsia; specifically those genes directly involved in the pathogenesis. METHODS: We firstly evaluated the consensus between 12 prioritization strategies to early recognize pathogenic genes related to preeclampsia. A communality analysis in the protein-protein interaction network of previously selected genes was done including further enrichment analysis. The enrichment analysis includes metabolic pathways as well as gene ontology. Microarray data was also collected and used in order to confirm our results or as a strategy to weight the previously enriched pathways. RESULTS: The consensus prioritized gene list was rationally filtered to 476 genes using several criteria. The communality analysis showed an enrichment of communities connected with VEGF-signaling pathway. This pathway is also enriched considering the microarray data. Our result point to VEGF, FLT1 and KDR as relevant pathogenic genes, as well as those connected with NO metabolism. CONCLUSION: Our results revealed that consensus strategy improve the detection and initial enrichment of pathogenic genes, at least in preeclampsia condition. Moreover the combination of the first percent of the prioritized genes with protein-protein interaction network followed by communality analysis reduces the gene space. This approach actually identifies well known genes related with pathogenesis. However, genes like HSP90, PAK2, CD247 and others included in the first 1% of the prioritized list need to be further explored in preeclampsia pathogenesis through experimental approaches.

The health educator network as a nutrition education strategy: the example of the EDALNU programme (1963-1994) / La red de promotores de salud como estrategia de educación alimentaria: el ejemplo del Programa EDALNU (1963-1994).

Food and nutrition education is an essential tool to ensure public health. The year 1961 saw the launch of the Food and Nutrition Education Programme (EDALNU), which helped Spanish population to complete their nutrition transition. The aim of this study was to analyze the characteristics of the health education network which was created as part of the program. A total of 46,752 people, 94% of whom were women, received training on food and nutrition. Of these, 89.54% obtained the basic certificate, and 8.80% were awarded the diploma. Some 1,407 courses were given, reaching a peak in 1979 with 131 courses and 4,029 students. The most active provinces were Madrid, with 26.65% of the courses; Valencia, with 7.60%; Murcia, with 7.53%, and Malaga, with 6.75%. The Spanish Ministry of Culture and Education organized the largest number of courses (26.23%), followed by the Women's Section (11.16%) and Catholic Action (5.12%). Diploma courses were taught for 160 hours, while basic courses lasted 40 hours. The training delivered was affected by changes in the EDALNU program and the Spanish administrative and political structure. Our research revealed that the development and gender balance of the network of trainers presented regional inequalities, and that a wide range of institutions were involved in delivering the courses

La educación en alimentación y nutrición es una herramienta fundamental para garantizar la salud. En 1961, se puso en marcha el Programa de Educación en Alimentación y Nutrición (EDALNU), que ayudó a la población española a completar su transición alimentaria y nutricional. El objetivo de este trabajo es analizar las características de la red de promotores de salud que se desarrolló en el marco del programa. Recibieron formación relacionada con alimentación y nutrición 46.752 personas, el 94% de ellas mujeres. El 89,54% obtuvo el título de iniciado y el 8,80%, el de diplomado. Se realizaron 1.407 acciones y en 1979 se alcanzó el momento más álgido, con 131 cursos y 4.029 alumnos. Madrid, con el 26,65% de cursos; Valencia, con el 7,60%; Murcia, con el 7,53%, y Málaga, con el 6,75%, fueron las provincias más activas. El Ministerio de Cultura y Educación fue el encargado de organizar el mayor número de cursos (26,23%), seguido de Sección Femenina (11,16%) y Acción Católica (5,12%). La duración y los contenidos formativos de los cursos eran de 160 horas para los diplomados y 40 para los iniciados. La acción formativa desarrollada estuvo sometida a los cambios que experimentó el Programa y a los que afectaron a la estructura administrativa y política española. La investigación ha mostrado las desigualdades territoriales que acompañaron el desarrollo de la red de formadores, su componente de género y el carácter plural de las instituciones que organizaron los cursos.