Efficacy and acceptability of music therapy for post-traumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials.

Background: Music therapy is increasingly examined in randomized controlled trials (RCTs) and shows potential in treating post-traumatic stress disorder (PTSD).Objective: This systematic review and meta-analysis critically evaluates the current clinical evidence supporting the efficacy and acceptability of music therapy for PTSD.Method: RCTs comparing music therapy in addition to care as usual (CAU) versus either CAU alone or CAU combined with standard psychotherapy/pharmacotherapy for PTSD were retrieved from major English - and Chinese-language databases. Standardized mean differences (SMDs) for post-treatment PTSD symptom scores and risk differences (RDs) for retention rates upon treatment completion were calculated to assess the efficacy and acceptability of music therapy, respectively. The Cochrane risk of bias (RoB) tool 2.0 and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) were used to assess the RoB of included studies and certainty of the evidence, respectively.Results: Nine studies, incorporating 527 PTSD patients, were included, all with high RoB. The post-treatment PTSD symptom scores were significantly lower in the music therapy group than the inactive control group (SMD = -1.64, P < .001), but comparable between the music therapy group and the active control group (SMD = -0.28, P = .330). The retention rates did not differ significantly between the music therapy group and both control groups (RD = 0.03, P = .769; RD = 0.16, P = .829). The GRADE rated certainty level of evidence as low.Conclusions: Although meta-analytic findings suggest that music therapy is effective in reducing post-traumatic symptoms in individuals with PTSD, with its therapeutic effect comparable to that of standard psychotherapy, the low level of certainty limits its generalizability. More methodologically stringent studies are warranted to strengthen the clinical evidence for the efficacy and acceptability of music therapy for PTSD.

This systematic review critically appraised the existing methodologically rigorous evidence for the efficacy and acceptability of music therapy for post-traumatic stress disorder (PTSD).The post-treatment PTSD symptom scores were significantly lower in the music therapy group than the inactive control group and comparable between the music therapy group and the active control group.The post-treatment retention rates did not differ significantly between the music therapy group and both the inactive and active control groups.

How are experiences and acceptability of child maltreatment related to resilience and posttraumatic growth: a cross cultural study.

Background: Post-traumatic growth (PTG) and resilience, regarded as positive psychological change following a traumatic experience, are under-researched across cultures in people exposed to child maltreatment (CM).Objective: We investigated how experiences and the perceived acceptability of CM are related to resilience and PTG in countries with different cultures, living standards, and gross national income.Method: A total of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) completed an online survey with self-reported questionnaires, including the Brief Resilience Scale and the Post Traumatic Growth Inventory-Short Form.Results: Across countries, self-reported male gender and age were positively associated with resilience, while experiences of physical abuse and emotional maltreatment were negatively associated with resilience. Experiences of emotional maltreatment were positively associated with PTG. Higher levels of PTG and resilience were found amongst Cameroonian participants as compared to other countries.Conclusion: Our results suggest that positive changes following CM can vary significantly across cultures and that experiences of specific CM subtypes, but not the perceived acceptability of CM, may be important for a deeper understanding of how individuals overcome trauma and develop salutogenic outcomes. Our findings may inform CM intervention programmes for an enhanced cultural sensitivity.

Across the four countries (Canada, Cameroon, Germany, Japan), more experiences of physical abuse and emotional maltreatment were associated with lower resilience; more experiences of emotional maltreatment were associated with greater post-traumatic growth.Higher levels of post-traumatic growth and resilience were found in Cameroon as compared to other countries.Positive changes following child maltreatment vary across cultures and experiences of specific child maltreatment subtypes, but the perceived acceptability of child maltreatment did not exert an influence on salutogenic post-traumatic outcomes.

The acceptability of a guided internet-based trauma-focused self-help programme (Spring) for post-traumatic stress disorder (PTSD).

Background: Guided internet-based, cognitive behavioural therapy with a trauma-focus (i-CBT-TF) is recommended in guidelines for post-traumatic stress disorder (PTSD). There is limited evidence regarding its acceptability, with significant dropout from individual face-to-face CBT-TF, suggesting non-acceptability at least in some cases.Objective: To determine the acceptability of a guided internet-based CBT-TF intervention, 'Spring', in comparison with face-to-face CBT-TF for mild to moderate PTSD.Method: Treatment adherence, satisfaction, and therapeutic alliance were measured quantitatively for participants receiving 'Spring' or face-to-face CBT-TF as part of a Randomised Controlled Trial. Qualitative interviews were conducted with a purposive sample of therapists and participants.Results: 'Spring' guided internet-based CBT-TF was found to be acceptable, with over 89% participants fully or partially completing the programme. Therapy adherence and alliance for 'Spring' and face-to-face CBT-TF did not differ significantly, apart from post-treatment participant-reported alliance, which was in favour of face-to-face CBT-TF. Treatment satisfaction was high for both treatments, in favour of face-to-face CBT-TF. Interviews with participants receiving, and therapists delivering 'Spring' corroborated its acceptability.Conclusions: Guided internet-based CBT-TF is acceptable for many people with mild to moderate PTSD. Findings provide insights into future implementation, highlighting the importance of personalising guided self-help, depending on an individual's presentation, and preferences.

Guided internet-based trauma-focused CBT is an acceptable treatment for PTSD.A model of acceptability explained 45% of variance in treatment outcome.Importance of adapting guided self-help to suit presentation and preferences.

Feasibility, acceptability, and effectiveness of web-based and mobile PTSD Coach: a systematic review and meta-analysis.

Background: Timely and effective interventions can alleviate or prevent the development of clinical symptomatology in trauma-exposed individuals. However, due to limited access to these interventions, and/or stigma around accessing mental health services, there is an unmet need. Internet-and mobile-based interventions may help to address this need.Aims: This review aims to (i) synthesise the evidence on feasibility, acceptability, and effectiveness of the 'PTSD Coach' intervention (both web-based and mobile applications) in trauma-exposed individuals; (ii) evaluate the quality of this research; and (iii) identify challenges and recommendations related to 'PTSD Coach' intervention delivery.Method: Systematic database searches were conducted (PubMed/MEDLINE, PsycINFO, EMBASE, PLoS, Web of Science, PTSDpubs, Scopus, and clinical trial databases). Review inclusion was based on predefined inclusion criteria, and study quality was assessed with the mixed methods appraisal and the risk-of-bias tools for randomised trials. Where feasible, meta-analytical pooling of intervention effects on posttraumatic stress symptoms (PTSS) was conducted.Results: Seventeen manuscripts reporting on 16 primary studies were included with the majority evaluating a self-managed PTSD Coach mobile application intervention. Most studies were conducted in higher-income countries and females were over-represented. For both platforms, satisfaction and perceived helpfulness were generally high but type of smart device operating system was identified as an influence. The pooled effect size in symptom severity in the intervention group compared to the comparison group was not significant (standardised mean difference =  - 0.19) (95% CI - 0.41 to - 0.03, p = .09). Heterogeneity was not significant (p = .14; I2 = 40%). No study was excluded based on quality assessment.Conclusion: Findings support the feasibility and acceptability of 'PTSD Coach' in trauma-exposed individuals. However, evidence on the effectiveness on PTSS remains limited. More research is still needed in low-middle-income countries, particularly those in which supported 'PTSD Coach' interventions are evaluated in larger and more diverse samples.

Most studies evaluated a self-managed PTSD Coach mobile application intervention in higher-income countries.Findings generally support the feasibility and acceptability of both PTSD Coach mobile application and PTSD Coach Online in trauma-exposed individuals but the evidence on the effectiveness on posttraumatic stress symptoms remains limited.More research is needed especially in low-middle-income countries where there is often limited access to the needed interventions.

Identificación de factores que se asocian a alto riesgo de desarrollar diabetes gestacional / Identification of factors associated with a high risk of developing gestational diabetes

Objetivos: Principal. Determinar la prevalencia de los factores de riesgo reconocidos para diabetes gestacional (DG) en nuestra población. Definir el perfil de las pacientes con mayor riesgo de desarrollar DG. Secundario. Analizar la aceptabilidad por parte de las gestantes de las pruebas de cribado. Material y método: Se trata de un estudio observacional ambispectivo en el que se reclutaron 1448 gestantes en un único centro, entre el 1 de diciembre de 2017 y el 31 de julio de 2019. Los criterios de inclusión fueron: no antecedente de diabetes mellitus pregestacional, no antecedente de DG en gestación previa, no antecedentes de cirugía bariátrica, haber realizado cribado para DG en la actual gestación. Resultados: La prevalencia de DG en nuestra población fue del 6,7%. Los factores de riesgo que se asociaron con el desarrollo de DG en nuestra población fueron: edad≥27,5 años (OR: 3,8; IC95%: 2,01-9,16), IMC≥28,5kg/m2 (OR: 2,3; IC95%:1,47-3,59); antecedente de diabetes mellitus en familiares de primer grado (OR: 2,3; IC95%: 1,5-3,66) y la gestación múltiple (OR: 2,8; IC95%: 0,86-6,36). La prevalencia de la DG se incrementó según lo hacía el número de factores de riesgo encontrados en la gestante: desde el 1,4% en las pacientes sin los factores de riesgo hasta el 25.2% con 3 factores de riesgo presentes. El 26,8% de las pacientes calificaron como desagradable la realización del test de ÓSullivan (50g glucosa) y el 65,4% la prueba de sobrecarga oral con 100g de glucosa. Conclusiones: La edad de la gestante≥27,5, el IMC≥28,5kg/m2, el antecedente de diabetes mellitus en familiares de primer y la gestación múltiple son factores que se asocian con alto riesgo de desarrollar DG; estos factores serían suficientes para identificar a la mayoría de las gestantes que desarrollarán DG. Nuestros resultados pueden aplicarse para mejorar los programas de atención prenatal destinados al diagnóstico y tratamiento precoz de la DG.(au)

Objectives: The main objective is to determine the current prevalence of recognised risk factors for gestational diabetes mellitus (GDM) in our region, and to define the profile of patients at higher risk of developing this condition. We also investigate patient acceptability of the screening tests. Material and methods: This is an ambispective study with 1,448 pregnant women recruited between December 2017 and July 2019 from a single centre. Inclusion criteria were no diabetes mellitus prior to the pregnancy, no history of GDM in any previous pregnancy, no history of bariatric surgery before the pregnancy, and GDM screening tests performed. Results: The prevalence of GDM was 6.7%. Risk factors associated with development of GDM were: age≥27.5 years (OR: 3.8; 95% CI: 2.01-9.16); BMI≥28.5kg/m2 (OR: 2.3; 95% CI: 1.47-3.59); history of diabetes mellitus in first-degree relatives (OR: 2.3; 95% CI: 1.5-3.66); and multiple pregnancy (OR: 2.8; 95% CI: 0.86-6.36); Prevalence of GDM increased with the number of risk factors presented by patients: from 1.4% with no risk factor, to 25.2% with 3. The O'Sullivan test (50g glucose) and oral glucose tolerance test (100g glucose) were perceived as “unpleasant” by 26.8% and 65.4% of patients, respectively. Conclusions: Age≥27.5 years, BMI≥28.5kg/m2, history of diabetes mellitus in first-degree relatives, and multiple pregnancy are factors related to an increased risk of GDM; these factors would be enough to identify most pregnant women developing GDM. Our findings may be used to improve programmes aimed at early diagnosis of gestational diabetes and supporting high-risk mothers in antenatal care.(AU)

Study on the use, acceptability and implementation of the Unified Protocolin general health psychologists in Spain / Estudio sobre el uso, aceptabilidad e implementación del Protocolo Unificado en psicólogos generales sanitarios en España

The dissemination of evidence-based psychological treatments (EBPT) is a pending task for Clinical Psychology. Through an online sur-vey and following the Theoretical Framework of Acceptability, we ana-lyzed the opinions about use, acceptability and intention to use in the fu-ture of the Unified Protocol for the transdiagnostic treatment of emotional disorders (UP) in a sample of 153 professionals of General Health Psy-chology (GHPs). All participants took a training course in the UP and were grouped depending on their previous experience in the UP application. The results showed high scores in acceptability and intention to use in the future in GHPs regardless of the group. Finally, statistically significant cor-relations were found between intention to use in the future and affective attitude, consistency of the intervention and perceived efficacy (in both groups) and self-efficacy (in the group of GHPs without experience in the use of UP). The UP is an EBPT that presents high levels of acceptance and intention to use by the GHPs who received training in this interven-tion, this will facilitate its dissemination and implementation and will allow a greater number of people to benefit from this treatme.(AU)

La diseminación de tratamientos psicológicos basados en la evidencia (TPBE) es una tarea pendiente para la Psicología Clínica. A través de una encuesta online y siguiendo el Modelo Teórico sobre Aceptabilidad, analizamos las opiniones sobre el uso, aceptabilidad e intención de uso en el futuro del Protocolo Unificado para el tratamiento transdiagnóstico de los trastornos emocionales (PU) en una muestra de 153 profesionales de la Psicología General Sanitaria (PGS). Todos los participantes habían realizado un curso de formación sobre el PU y se agruparon según su experiencia previa con la aplicación del PU. Los resultados mostraron altas puntuaciones en aceptabilidad e intención de uso en los PGS con independencia del grupo. Se encontraron correlaciones estadísticamente significativas entre la intención de uso en el futuro y la actitud afectiva, coherencia de la intervención y eficacia percibida (en ambos grupos) y autoeficacia (en el grupo de PGS sin experiencia en el uso del PU). El PU es un TPBE que presenta altos niveles de aceptación e intención de uso por parte de los PGS que recibieron formación en esta intervención, esto facilitará su diseminación e implementación y permitirá que un mayor número de personas puedan beneficiarse de este tratamiento.(AU)

Greek vs traditional yogurts: Sensory and physicochemical comparison

ABSTRACT Greek yogurt (GY) has gained popularity in recent years for its marked texture, taste, and nutritional characteristics compared to traditional yogurt (TY). The objective of this work was to analyze the physicochemical, sensory, and lipid profile of GY and TY with blueberry flavor, both manufactured by a local industry in the state of Rio Grande do Sul, Brazil. Protein and lipid content, as well as humidity, ash, and fatty acid profile were quantified and a sensory evaluation was completed using the affective method. The physicochemical results showed 1.5% and 2.3% more proteins and lipids, respectively, for GY compared to TY. The humidity in TY was 10% lower than in GY. Eighteen types of polyunsaturated, saturated, monounsaturated fatty acids were identified, with a high proportion of C14, C16, and C18. Sensory analysis showed a preference for GY over TY (64% versus 36%, p0.05). Both the protein and lipid content, associated with creaminess, likely influence better acceptance of GY.

RESUMEN El yogur griego (YG) ha ganado popularidad durante los últimos años por su marcada textura, sabor y características nutricionales en comparación con el yogur tradicional (YT). El objetivo de este trabajo fue analizar el perfil fisicoquímico, sensorial y lipídico de YG y YT con sabor a arándano, ambos fabricados por una industria ubicada en el estado de Rio Grande do Sul, Brasil. Fueron cuantificados el contenido de proteínas, lípidos, humedad y cenizas, así como también el perfil de ácidos grasos y la evaluación sensorial por método afectivo. Los resultados fisicoquímicos mostraron que YG contiene 1,5% y 2,3% más de proteínas y lípidos, respectivamente, en comparación con YT (p0,05) en relación a la aceptación de los atributos color, olor, sabor y acidez. Los atributos cuerpo, apariencia y textura presentaron mejores scores de aceptación para el YG. Tanto el contenido de proteínas y lípidos, asociados a la cremosidad, probablemente hayan influenciado una mejor aceptación del YG.

Aceptabilidad de la autotoma como método de cribado de cáncer de cérvix en mujeres de la Región de Murcia / Acceptability of self-sampling as a method for cervical cancer screening among women from the Region of Murcia (Spain)

Fundamentos: Actualmente existe poca evidencia publicada sobre la aceptabilidad de la autotoma como prueba inicial de cribado del cáncer de cérvix en una población de mujeres que acuden a cribado regularmente. El objetivo del estudio fue determinar la aceptabilidad de la autotoma en mujeres de la Región de Murcia (RM) como prueba primaria de cribado. Métodos: Estudio transversal mediante encuesta telefónica a una muestra de 247 mujeres entre 35-65 años de la RM entre abril-mayo de 2021. Se recogieron las características sociodemográficas, los conocimientos, actitudes frente a los cribados de cáncer y valoración de la autotoma. Se realizó un análisis ponderado descriptivo, bivariante y regresión logística multivariante para determinar las características de las participantes relacionadas con su preferencia por la autotoma frente a la toma realizada por un profesional sanitario. Resultados: El 89,4% de las mujeres refirieron realizarse alguna citología en los últimos 5 años, el 88,7% de ellas con una frecuencia ≤3 años. El 81% de las mujeres prefirieron la autotoma como prueba primaria de cribado para la detección del cáncer de cérvix. No se detectaron características relacionadas con la preferencia de la autotoma frente a la toma por un profesional sanitario (P-ajustado≥0,05). Los principales inconvenientes valorados de la autotoma fueron la factibilidad (23,3%) y fiabilidad de la prueba (14,8%). Conclusiones: La aceptabilidad de la autotoma fue elevada entre las mujeres encuestadas de la RM. Sería conveniente valorar este método junto a una estrategia adecuada de educación a las mujeres dentro del programa de prevención del cáncer de cérvix.(AU)

Background: Current literature is insufficient to determine the acceptability of self-sampling as a primary method for cervical cancer screening among women from a regular screening population. The aim of this study was to determine the acceptability of selfsampling among women in the Region of Murcia as a primary screening tool. Methods: We performed a cross-sectional study between April-May 2021, in a regional sample of 247 women ages 35-65 years. All participants were contacted and completed a survey by telephone which included sociodemographic characteristics, knowledge and attitudes towards cancer screening, and self-sampling assessment. We conducted weighted statistical analysis including descriptive, bivariate and a multivariate logistic regression model to examine the associations between women’s characteristics and their preference for selfsampling compared to clinician sampling. Results: A total of 89.4% of participants reported at least one previous cytology in the last 5 years, 88.7% with a frequency equal to or less than 3 years. Eighty-ne percent of women preferred self-sampling over clinical sampling as a primary screening method. Basal characteristics were unrelated to women’s preference for self-sampling (P-adjusted≥0.05). Feasibility and reliability were the main concerns perceived in relation to self-sampling (23.3% and 14.8%, respectively). Conclusions: Acceptability of self-sampling was high among women in the Region of Murcia. Selfsampling in conjunction with an adequate educational strategy could be a suitable approach to consider in the cervical cancer screening program.(AU)

Masaje de Field para la ganancia de peso en prematuros extremos. Estudio de viabilidad y aceptabilidad / Field massage for weight gain in extremely premature babies. Feasibility and acceptability study

Introducción: Una de las principales problemáticas del prematuro extremo es la limitación en su ganancia de peso debido a factores propios de su inmadurez (2,4); el desconocimiento acerca del tipo, el tiempo y la cantidad de estimulación que debe recibir, rescata la necesidad de indagar en nuevas intervenciones desde el cuidado de enfermería (4,11). Objetivo: Determinar la viabilidad y aceptabilidad de la terapia de masaje de Field, en prematuros extremos en una Unidad Neonatal de una institución de IV nivel, y los efectos en relación con la ganancia de peso. Metodología: Estudio cuantitativo, cuasi experimental, realizado en 15 prematuros extremos, que comparó el peso pre y post intervención, y un análisis para la estimación del efecto; se determinó la viabilidad del estudio mediante tasas de selección, reclutamiento y seguimiento y la aceptabilidad de la intervención en términos de satisfacción de los padres. El proceso de selección y reclutamiento se efectuó por más de 4 meses; la terapia se realizó 3 veces al día, durante 15 minutos, por 5 días consecutivos; posteriormente, se aplicó un cuestionario de aceptabilidad a las madres de los neonatos masajeados. Resultados: Se presentó una ganancia de peso significativa, lo cual podría ser atribuido al masaje, sin embargo, debe ser evaluado en futuras investigaciones frente a un grupo control. El estudio se hace menos viable en cuanto a la tasa de selección, si la muestra es captada durante poco tiempo, reduciendo la posibilidad de aplicar la intervención en una muestra significativa; en cuanto a reclutamiento y seguimiento, es totalmente viable. Es una terapia muy aceptada por las madres en términos de idoneidad, conveniencia y efectividad; sin embargo, se debe fortalecer desde sus riesgos y adherencia.

Introduction: One of the main problems of the extreme premature infants is the limitation in their weight gain due to factors inherent to their immaturity (2,4), the lack of knowledge about the type, the time, and the amount of stimulation they should receive, it also highlights the need to investigate new interventions in nursing care (4,11). Objective: To determine the feasibility and acceptability of Field's massage therapy in extreme premature infants in a Neonatal Unit of a level IV institution, and the effects in relation to weight gain. Methodology: Quantitative, quasi-experimental study, carried out in 15 extreme preterm infants, where pre and post intervention weight was compared, a analysis for effect estimation; the feasibility of the study was determined by selection, recruitment and followup rates and the acceptability of the intervention in terms of parental satisfaction. The selection and recruitment process were carried out for more than 4 months; the therapy was performed 3 times a day, for 15 minutes per session, for 5 consecutive days; subsequently, an acceptability survey was applied to the mothers of the massaged neonates who completed the intervention days. Results: here was a significant weight gain, which could be attributed to the massage, however, it should be evaluated in future research against a control group. The study becomes less viable in terms of the selection rate, if the sample is captured for a short time, reducing the possibility of applying the intervention in a significant sample; in terms of recruitment and follow-up, it is totally feasible. It is a therapy that is highly accepted by mothers in terms of suitability, convenience and effectiveness; however, it must be strengthened from its risks and adherence.

Aceptabilidad del uso de dispositivos con interfaces de usuarios en la rehabilitación motora neurológica / Acceptability Of The Use Of Devices With User Interfaces In Neurological Motor Rehabilitation

Introducción: El avance de las nuevas tecnologías ha contribuido a elevar las opciones de interacción de las personas con los productos a partir del empleo de las interfaces de usuario. El uso de dispositivos con interfaces de usuario, diseñados como soportes orientados a la rehabilitación neurológica, puede potenciar y diversificar este proceso en contextos intra hospitalarios y extra hospitalarios. Objetivo: Identificar los criterios que determinan la aceptabilidad de estos dispositivos en la rehabilitación motora de pacientes con enfermedades neurológicas. Métodos: La muestra estuvo conformada por 31 pacientes del Instituto de Neurología y Neurocirugía tributarios de rehabilitación motora y un grupo control (N = 62) con sujetos sanos. Se construyó un cuestionario con 32 ítems que exploran los criterios de aceptabilidad de las interfaces de usuario. La versión final del cuestionario se obtuvo de la evaluación según criterio de expertos y el cálculo de la consistencia interna mediante el alfa de Cronbach. A los valores obtenidos durante la aplicación del cuestionario se les realizó un análisis factorial usando como método de rotación el varimax normalizado. El criterio para extracción de factores fue el método de autovalores de Scree. Resultados: La aceptabilidad del uso de dispositivos con interfaces de usuario está condicionada por tres categorías fundamentales: seguridad, expectativas y facilidad de asimilación. Conclusiones: La aceptabilidad de estos dispositivos depende de garantizar la seguridad en su uso, cumplir con las expectativas de una rehabilitación autónoma y hacer evidente y viable su facilidad de asimilación. Contar con estos criterios redunda en la obtención de requerimientos ergonómicos para el diseño de estos dispositivos(AU)

Introduction: The advance of new technologies has contributed to raising the interaction options of people with products from the use of user interfaces. The use of devices with user interfaces, designed as supports aimed at neurological rehabilitation, can enhance and diversify this process in intra-hospital and extra-hospital contexts. Objective: Identify the criteria that determine the acceptability of these devices in the motor rehabilitation of patients with neurological diseases. Methods: The sample consisted of 31 patients from the Institute of Neurology and Neurosurgery who needed motor rehabilitation and a control group (N = 62) with healthy individuals. A questionnaire with 32 items was created and it explored the acceptability criteria of user interfaces. The final version of the questionnaire was obtained from the evaluation according to expert criteria and the calculation of internal consistency using Cronbach's alpha. To the values obtained during the application of the questionnaire, there was performed a factor analysis using the normalized varimax as the rotation method. The criterion for factor extraction was the Scree eigenvalue method. Results: The acceptability of the use of devices with user interfaces is conditioned by three fundamental categories: security, expectations and ease of assimilation. Conclusions: The acceptability of these devices depends on guaranteeing safety in their use, meeting the expectations of an autonomous rehabilitation and making evident and viable their ease of assimilation. Having these criteria, results in obtaining ergonomic requirements for the design of these devices(AU)

Acceptance, refusal, and hesitancy of Covid-19 vaccination in Mexico: Ensanut 2020 Covid-19 / Aceptabilidad, rechazo y duda ante la vacunación contra Covid-19 en México: Ensanut 2020 Covid-19

Abstract: Objective: To estimate the willingness to vaccinate against Covid-19 (acceptance) in the Mexican population and to identify socioeconomic factors associated with vaccine hesitancy and refusal. Materials and methods: We estimated the acceptance, refusal and hesitancy proportions using data from the Covid-19 National Health and Nutrition Survey conducted from August to November 2020. Factors associated with refusal and hesitancy were explored using multinomial logistic regression. Results: Covid-19 vaccination acceptance was 62.3%, refusal 28.2% and hesitancy 9.5%. Refusal and hesitancy were associated with being female, having older age, lower educational level, lower socioeconomic status and working in the informal sector. Conclusion: National campaigns to incentivize vaccine acceptance need to consider specific subgroups were the likelihood of hesitancy and refusal is high. In Mexico, refusal and hesitancy were higher in vulnerable groups, and people at a higher risk of Covid-19 complications and death.

Resumen: Objetivo: Estimar la aceptabilidad de la vacunación contra Covid-19 en la población mexicana e identificar factores socioeconómicos asociados con el rechazo o la duda. Material y métodos: Se estimó la proporción de aceptabilidad, rechazo y duda utilizando los datos de la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19 levantada durante agosto y noviembre de 2020. Se exploraron los factores asociados con rechazo y duda mediante un modelo de regresión multinomial. Resultados: La aceptabilidad de la vacunación contra Covid-19 fue de 62.3%, el rechazo de 28.2% y la duda de 9.5%. El rechazo y la duda se asociaron con ser mujer, tener mayor edad, menor nivel de educación, menor nivel socioeconómico y trabajar en el sector informal. Conclusión: Las campañas para incentivar la aceptabilidad de la vacuna necesitan considerar los subgrupos específicos con una alta proporción de rechazo y duda. En México observamos un mayor rechazo y duda en grupos con mayor riesgo de complicaciones y muerte por Covid-19.

A meta-analysis of dropout from evidence-based psychological treatment for post-traumatic stress disorder (PTSD) in children and young people.

Background: Despite the established evidence base of psychological interventions in treating PTSD in children and young people, concern that these trauma-focused treatments may 'retraumatise' patients or exacerbate symptoms and cause dropout has been identified as a barrier to their implementation. Dropout from treatment is indicative of its relative acceptability in this population. Objective: Estimate the prevalence of dropout in children and young people receiving a psychological therapy for PTSD as part of a randomized controlled trial (RCT). Methods: A systematic search of the literature was conducted to identify RCTs of evidence-based treatment of PTSD in children and young people. Proportion meta-analyses estimated the prevalence of dropout. Odds ratios compared the relative likelihood of dropout between different treatments and controls. Subgroup analysis assessed the impact of potential moderating variables. Results: Forty RCTs were identified. Dropout from all treatment or active control arms was estimated to be 11.7%, 95% CI [9.0, 14.6]. Dropout from evidence-based treatment (TFCBTs and EMDR) was 11.2%, 95% CI [8.2, 14.6]. Dropout from non-trauma focused treatments or controls was 12.8%, 95% CI [7.6, 19.1]. There was no significant difference in the odds of dropout when comparing different modalities. Group rather than individual delivery, and lay versus professional delivery, were associated with less dropout. Conclusions: Evidence-based treatments for children and young people with PTSD do not result in higher prevalence of dropout than non-trauma focused treatment or waiting list conditions. Trauma-focused therapies appear to be well tolerated in children and young people.

Antecedentes: A pesar de la base de evidencia establecida de intervenciones psicológicas en el tratamiento del TEPT en niños y gente joven, la preocupación por el que estos tratamientos focalizados en el trauma puedan 'retraumatizar' a los pacientes o exacerbar sus síntomas y causar abandono, ha sido identificada como una barrera para su implementación. El abandono del tratamiento es indicador de su aceptabilidad relativa en esta población.Objetivo: Estimar la prevalencia de abandono en niños y gente joven que reciben una terapia psicológica para el TEPT como parte de un ensayo aleatorizado controlado (RCT en su sigla en inglés).Métodos: Se realizó una búsqueda sistemática de la literatura para identificar RCTs de tratamientos basados en evidencia para el TEPT en niños y gente joven. Mediante metaanálisis de proporción se estimó la prevalencia de abandono. Los Odds Ratio compararon la probabilidad relativa de abandono entre diferentes tratamientos y controles. Mediante análisis de subgrupo se evaluó el impacto de potenciales variables moderadoras.Resultados: Se identificaron cuarenta RCTs. El abandono de todas las ramas de tratamiento o control activo se estimó en 11.7%, IC de 95% [9.0, 14.6]. El abandono de tratamientos basados en la evidencia (TF-CBTs y EMDR) fue de 11.2%, IC de 95% [8.2, 14.6]. El abandono de tratamientos sin foco en trauma o controles fue de 12.8%, IC de 95% [7.6, 19.1]. No hubo diferencia significativa en la probabilidad de abandono al comparar las diferentes modalidades. La entrega en grupos Individual y por legos versus profesionales, se asociaron a menor abandono.Conclusiones: Los tratamientos basados en evidencia para niños y gente joven con tept no resultan en una mayor prevalencia de abandono que los tratamientos sin foco en trauma o condiciones de lista de espera. las terapias focalizadas en el trauma parecen ser bien toleradas en niños y gente joven.

Caracterización química, degradabilidad ruminal y aceptabilidad por bovinos, de un subproducto de la industria del papel / Chemical characterization, ruminal degradability and bovine acceptability of a byproduct of the paper industry

RESUMEN Las variaciones climáticas pueden limitar la disponibilidad y la calidad de los forrajes. Se estudió un subproducto del papel (SIP) como alternativa a los forrajes en la ración de los bovinos. Se analizaron 12 muestras de SIP, para determinar su composición nutricional y degradabilidad ruminal. La aceptabilidad (1,07kg MS) por los bovinos de los SIP solo o en mezcla, se evaluó en 12 novillas Holstein, asignadas a dos cuadrados latinos, cada uno con tres tratamientos y dos réplicas. En el primer cuadrado, los tratamientos fueron SIP solo (T1); SIP+glicerol (T2) y SIP+melaza (T3). En el segundo, los tratamientos fueron SIP+suplemento comercial (SC) (T4); SIP+SC+glicerol (T5) y SIP+SC+melaza (T6). Los SIP presentaron bajos contenidos de PC (1,5±0,14%) y altos niveles de FDN (56,9±6,17%) y cenizas (53,3±1,98%) y una DIVMO (47,7±5,8%) media. Las concentraciones de P (0,045±0,006%) y K (0,023±0,03%) fueron bajas, mientras que las de Ca (13,5±0,8%), Cu (63,9±11,5%) y Fe (1365±189ppm) fueron altas. La tasa de desaparición de la MS del SIP fue de 11,8%*h-1; la fracción soluble ( a ), 14% y la fracción potencialmente degradable y no soluble ( b ), 46,6%. La aceptabilidad del SIP fue mayor, cuando se ofreció en mezclas (T1 vs T2-T3; p<0,05) y con concentrado y melaza (T4-T5 vs T6; p<0,05). La variación en la calidad composicional del SIP fue menor para la mayoría de nutrientes y su calidad baja, debido a una digestibilidad media, una baja PC y altas cenizas. Además, su aceptabilidad fue pobre cuando se suministró sola, pero mejoró con el uso de palatabilizantes o SC.

ABSTRACT Climatic variations can limit the availability and quality forages. The use of byproducts of the paper industry (BPI) was studied as part of cattle rations. Twelve samples of BPI were analyzed to determine the nutritional composition and ruminal degradability. The acceptability (1.07kg DM) of the BPI was evaluated in 12 Holstein heifers, assigned to two Latin squares with two replicates and three treatments each. The first square, the treatments were BPI alone (T1), BPI +glycerol (T2) and BPI +molasses (T3). In the second square, treatments were BPI +commercial supplement (CS) (T4), BPI +CS +glycerol (T5) and BPI + CS + molasses (T6). The BPI presented low CP (1.5±0.14%), high levels of NDF (59.6±6.17%) and ash (53.3±1.98%) and médium IVODM (47.7±5.8%). Concentrations of P (0.045±0.06%) and K (0.023±0.03%) were low while Ca (13.5±0.8%), Cu (63.9±11.5ppm) and Fe (1365±189ppm) high. Rate of DM disappearance for BPI was 11.8%*h-1, soluble fraction ( a ) 14% and a potentially degradable fraction but not soluble ( b ) 46.6%. The acceptability of BPI was higher when fed in mix (T1 vs T2-T3; p<0.05) and with concentrate and molasses (T4-T5 vs T6; p<0.05). Variation in nutritional composition of BPI was low for most and its nutritional quality low due to a moderate digestibility, a low CP and high ash. In addition, its acceptability was low but improved when supplied with the use of palatability agents and CS.

Ética y jurisprudencia administrativa de los derechos de los sujetos de investigación en pandemia (COVID-19): función de los comités éticos científicos: Chile / Ethics and administrative jurisprudence of the rights of subjects of research in pandemic (COVID-19): role of the scientific ethics committees: Chile

RESUMEN: Todo gobierno debe reaccionar rápida y efectivamente ante cualquier pandemia, Chile no es la excepción y apoyado en el estado de Excepción Constitucional, ha tenido que implementar medidas que podrían involucrar poca información sobre las percepciones de las personas y las reacciones durante la implementación de las restricciones. Las instituciones internacionales de salud han determinado que es un deber moral realizar investigaciones que generen evidencia que promuevan y mejoren la atención de la salud y la mitigación de la pandemia, instando a reducir los "obstáculos" prácticos de la revisión ética. Los objetivos de este trabajo fueron analizar desde las perspectivas de las consideraciones éticas y jurídicas, el rol que cumplen los Comités Éticos Científicos en el manejo y la protección de las personas durante la pandemia de la COVID-19. La metodología de trabajo se basó en la recolección de la información de Instituciones nacionales e internacionales de Salud y luego analizarla según la jurisprudencia administrativa del gobierno de Chile. Se concluye que los cambios de criterios que deben observar los CECs en el proceso de revisión de los protocolos de los proyectos de investigación científica, deben velar por proteger los derechos de los pacientes y sujetos de investigación en cuanto puede involucrar información sensible, más aún, si se consideran las graves consecuencias de su transgresión, dar un sentido distinto al que corresponda a las normas sobre derechos de pacientes, puede resultar en "falta de servicio" y eventual vulneración en los derechos del sujeto de investigación. La labor de los CEC, debe realizarse siempre desde una interpretación restrictiva, reconociendo la función pública que cumplen como parte integrante de la labor ética encomendada por el legislador al efecto.

SUMMARY: Every government must react quickly and effectively to any pandemic, Chile is no exception and supported by the state of Constitutional Exception, it has had to implement measures that could involve little information about people's perceptions and reactions during the implementation of the restrictions. International health institutions have determined that it is a moral duty to carry out research that generates evidence that promotes and improves health care and the mitigation of the pandemic, urging to reduce the practical "obstacles" to ethical review. The objective of this study was to analyze from the perspectives of ethical and legal considerations, the role that Scientific Ethics Committees play in the management and protection of people during the COVID-19 pandemic. The methodology used was based on collecting information from national and international Health Institutions and then analyzing it according to the administrative jurisprudence of the Chilean government. It is concluded that the changes in criteria that the CECs must observe in the process of reviewing the protocols of scientific research projects, must ensure the protection of the rights of patients and research subjects insofar as it may involve sensitive information, even more if the serious consequences of its transgression are considered. Giving a different meaning to the one that corresponds may result in "lack of service" and eventual violation of the rights of the research subject. The task of the CEC, must always be carried out from a restrictive interpretation, recognizing the public function that they fulfill as an integral part of the ethical work entrusted by the legislators to that effect.

Acceptability and adoption of clinical practice guidelines and treatment protocols on preeclampsia/eclampsia in the Dominican Republic / Aceptabilidad y adopción de guías de práctica clínica y protocolos de atención sobre preeclampsia-eclampsia en la República Dominicana / Aceitabilidade e adoção de diretrizes de prática clínica e protocolos de atenção para pré-eclâmpsia e eclâmpsia na República Dominicana

ABSTRACT Objective. Estimate the acceptability and adoption by health care workers of clinical practice guidelines and treatment protocols for women with preeclampsia/eclampsia and identify the facilitating factors and barriers to their implementation. Methods. A qualitative study was conducted, using semi-structured interviews and focus groups in five maternity hospitals. Interviews were compiled for analysis, and barriers and facilitators were characterized. Results. Seventy health professionals (52 female and 18 male) participated, representing different levels of the health system. The majority of workers and managers were aware of the existence and content of clinical practice guidelines (CPGs) for preeclampsia/eclampsia, especially the participants with more time in the health service. With respect to facilitating factors, both medical and nursing staff were positive about continued development and implementation of high-quality CPGs. There was consensus that limitations exist, especially with respect to a lack of the necessary medicines, supplies, and equipment to meet and implement the established recommendations. Discussion. The results of the study show the need to strengthen strategies that help close the gap between research and public policy. Studies suggest that research should focus on users, policymakers, and decisionmakers in the health system. The actors in the Dominican health system recognize the GRADE methodology as an appropriate instrument for the development and implementation of CPGs. Implementation barriers require systemic and comprehensive approaches.

RESUMEN Objetivo. Estimar la aceptabilidad y adopción de las guías de prática clínica (GPC) y protocolos de atención a la mujer con preeclampsia-eclampsia por parte del personal prestador de los servicios de salud, e identificar los factores facilitadores y las barreras para su implementación. Métodos. Se desarrolló un estudio cualitativo por medio de entrevistas semiestructuradas y grupos focales en cinco maternidades. Se recopilaron las entrevistas para su análisis y se caracterizaron las barreras y facilitadores. Resultados. Participaron 70 profesionales de la salud (52 de sexo femenino y 18 de sexo masculino) que se desempeñan en distintos niveles del sistema de salud, participaron. La mayoría de los prestadores y gerentes conocen la existencia de las GPC de eclampsia-preeclampsia y su contenido, sobre todo los participantes con más tiempo en el servicio. Para los facilitadores, se estableció una valoración positiva entre el personal médico y de enfermería ante el proceso de continuar con la elaboración e implementación de GPC de alta calidad. Hubo consenso en cuanto a la existencia de limitaciones, sobre todo, por la falta de medicamentos, insumos y equipos requeridos, para cumplir y aplicar las recomendaciones formuladas. Discusión. Los resultados del estudio exponen la necesidad de fortalecer estrategias que ayuden a cerrar la brecha entre la investigación y la política pública. Estudios fundamentan la investigación en priorizar la atención a los usuarios, y los encargados de formular políticas y los tomadores de decisiones en el sistema de salud. Los actores del sistema de salud dominicano reconocen la metodología GRADE como un instrumento apropiado para la formulación e implementación de GPC. Las barreras de implementación requieren de abordajes sistémicos e integrales.

RESUMO Objetivo. Estimar a aceitabilidade e a adoção de diretrizes de prática clínica (DPCs) e protocolos de atenção para mulheres com pré-eclâmpsia e eclâmpsia por profissionais da saúde e identificar os fatores facilitadores e barreiras à sua implementação. Métodos. Desenvolvemos um estudo qualitativo baseado em entrevistas semiestruturadas e grupos focais em cinco maternidades. As entrevistas foram coletadas para análise, sendo caracterizadas as barreiras e fatores facilitadores. Resultados. O estudo contou com a participação de 70 profissionais da saúde (52 mulheres e 18 homens) que trabalham em diferentes níveis do sistema de saúde. Em sua maioria, os profissionais e administradores estão cientes da existência de DPCs para pré-eclâmpsia e eclâmpsia e conhecem seu conteúdo, especialmente os que têm mais tempo de experiência. Em relação aos fatores facilitadores, os profissionais médicos e de enfermagem consideraram positivo o processo de elaboração e implementação de DPCs de alta qualidade. Houve consenso sobre a existência de limitações, especialmente no que diz respeito à falta de medicamentos, insumos e equipamentos necessários para cumprir e implementar as recomendações. Discussão. Os resultados do estudo deixam clara a necessidade de reforçar as estratégias que ajudam a estabelecer vínculos entre a pesquisa e as políticas públicas. A pesquisa futura deve priorizar a atenção aos usuários e o apoio aos decisores e responsáveis pela elaboração de políticas no sistema de saúde. Os atores do sistema de saúde dominicano reconhecem a metodologia GRADE como um instrumento apropriado para a formulação e implementação de DPCs. As barreiras à implementação exigem abordagens sistêmicas e abrangentes.

Evaluation of the acceptability of low glycaemic index preparations, formulated by replicating traditional Chilean culinary preparations with a high glycaemic index.

INTRODUCTION: The aim of this study was to determine the acceptability of low glycaemic index (GI) preparations, equivalent to the traditional high GI ones in Chile, elaborated with minimal changes in the ingredients and culinary techniques that significantly diminish the GI and maintain acceptability level. Twelve high-GI traditional lunches and their low GI counterparts were prepared. For 12 days, 20 apparently healthy women randomly tasted 2 paired preparations per day (low and high GI). The attributes of appearance, taste, smell, and texture of salads, main course, and desserts, as well as those of the full lunch, were evaluated using a hedonic scale of 7 and 9 points. Lunches with a high GI (90 ± 20.5 %) were modified by changing types of food ingredients, and/or by using culinary techniques to provide a low-GI counterpart with 47 ± 5.9 % GI (p < 0.001). All the preparations were classified as optimal, exceeding the established cut-off point. The "Legume with CHO" lunch had a higher acceptability level in its low GI version (p = 0.006), while the "Chicken with corn" lunch had it in its high GI version (p = 0.004). There was a preference for low-GI salad appearance (p = 0.003) and dessert flavour (p = 0.024), while high-GI main dishes were better praised for flavour (p = 0.034) and texture (p = 0.012). It is therefore possible to prepare low-GI menus equivalent to their traditional counterparts that are received as generally acceptable, with components and sensory attributes equal to, or even better than typical Chilean cuisine dishes.

INTRODUCCIÓN: El objetivo de este estudio fue determinar la aceptabilidad de preparaciones de bajo índice glicémico (IG) diseñadas a partir de aquellas de alto IG de consumo habitual en Chile, elaboradas con mínimos cambios en sus ingredientes y basándose en técnicas culinarias que diminuyen el IG. Doce preparaciones tradicionales de alto IG se eligieron para preparar sus homólogos de bajo IG. Durante 12 días, 20 mujeres en buen estado de salud probaron, de forma aleatoria, 2 preparaciones equivalentes por día (de bajo y alto IG), y evaluaron la aceptabilidad promedio de las ensaladas, los platos principales y los postres, así como el almuerzo completo, a través de una escala hedónica de 7 puntos y una de 9 puntos para evaluar aceptabilidad de los atributos: apariencia, sabor, olor y textura. Los almuerzos de alto IG (90 ± 20,5 %) se modificaron cambiando los tipos de ingredientes y las técnicas culinarias, formulando preparaciones homólogas de bajo IG (47 ± 5,9 %). Todas las nuevas preparaciones se calificaron de óptimas; las legumbres con cereales obtuvieron la más alta aceptabilidad en su versión de bajo IG (p = 0,006), mientras que el plato principal "Pollo con choclo" lo hizo en su versión de alto IG (p = 0,004). Hubo mayores preferencias por la apariencia de las ensaladas (p = 0,003) y el sabor de los postres de bajo IG (0,024), mientras que los platos principales fueron mejor valorados en cuanto a sabor (p = 0,034) y textura (0,012) en su versión de alto IG. Es posible preparar menus de bajo IG equivalentes a las preparaciones tradicionales de alto IG, con componentes y atributos sensoriales similares, o incluso mejores, que los de las preparaciones tradicionales chilenas originales.

Probabilistic cost-utility analysis and expected value of perfect information for the Oncotype multigenic test: a discrete event simulation model.

OBJECTIVE: To carry out a cost-utility analysis of the application of the Oncotype genomic test to inform the decision to use or not to use chemotherapy in the Basque Country (Spain). METHOD: The cost-utility study was carried out using a discrete event simulation model representing the natural history of breast cancer. The decision of treatment with chemotherapy based on Oncotype was compared with the standard of treatment based on clinical-pathological criteria. The model included clinical data from Basque hospitals and the literature and was processed by deterministic and probabilistic analysis to calculate the incremental cost-effectiveness ratio (ICER), the cost-effectiveness plane, the acceptability curve and the expected value of perfect information. The study adopted both a health and societal perspective. RESULTS: From a health perspective, the deterministic analysis estimated an ICER for Oncotype of 17,453 euros/quality-adjusted life year (QALY), discount included, and 9,613 euros/QALY without the discount. Eighty five percent (85%) of the simulations were below the efficiency threshold for Spain. The parametric variability associated with the Oncotype results was the main uncertainty factor in the decision. CONCLUSIONS: Oncotype is a cost-effective intervention from a health system perspective since each QALY gained costs less than 25,000 euros. From a societal perspective, it is dominant since it provides greater health and is accompanied by cost savings.

Desarrollo de una bebida mixta tipo néctar con cápsulas de Aloe vera (L.) Burm. f. y vitamina C / Development of a nectar-type mixed drink with Aloe vera (L.) Burm. f. and vitamin C capsules

RESUMEN El mercado de productos naturales, a nivel alimenticio, medicinal e industrial, se ha incrementado notablemente, promoviendo la innovación e investigación y el uso de materias primas vegetales y animales. La presente investigación tuvo como objetivo diseñar un néctar, con una combinación de matrices de frutas y de vegetales, como uva, espinaca, mora, agraz, yacón, enriquecida con cápsulas de Aloe vera y vitamina C. Se plantearon tres formulaciones, variando la cantidad de ingredientes en la mezcla; se seleccionó el tratamiento más aceptable, mediante evaluación sensorial en panel no entrenado. Todos los néctares tuvieron una buena aceptación organoléptica; no obstante, el 50% de los panelistas mostraron preferencias por el tratamiento 1, que contenía 13% de uva, 4% de espinaca, 3% de agraz y mora, 2% de yacón; el porcentaje restante correspondió a la cantidad de agua y azúcar empleada en la formulación. Al tratamiento con mayor aceptación (T1), se le analizaron los atributos físico químicos, mostrando un pH de 2,96, 12,11°Brix, color, olor y apariencia normales y estables; asimismo, se evaluó la presencia de bacterias mesófilas, hongos y levaduras, E. coli y Salmonella. Con el fin de enriquecer el producto, se elaboraron cápsulas de A. vera y vitamina C, para ser incorporadas en el néctar. Este tipo de producto promueve el consumo de frutas y de vegetales en alimentos procesados de uso frecuente, como los néctares.

ABSTRACT The market of natural products at a nutritional, medicinal and industrial level, has increased remarkably, promoting innovation and research and the use of vegetable and animal raw materials. The objective of this research was to design a nectar, with a combination of fruit and vegetable matrices such as grape, spinach, blackberry, blueberry, yacon, enriched with Aloe vera capsules and vitamin C. Three formulations were proposed varying the number of ingredients in the mixture; the most acceptable treatment was selected through sensory evaluation in an untrained panel. All the nectars had a good organoleptic acceptance, however, 50% of the panelists showed preferences for the treatment 1, it contained 13% of grape, 4% of spinach, 3% of blueberry and blackberry, 2% of yacon, the remaining percentage corresponded to the amount of water and sugar used in the formulation. To the treatment with greater acceptance (T1) the physical-chemical attributes were analyzed, showing a pH of 2.96; 12.11°Brix, color, smell and appearance normal and stable, likewise the presence of mesophilic bacteria, fungi and yeasts, E. coli and Salmonella was evaluated. In order to enrich the product, capsules of A. vera and vitamin C were prepared to be incorporated into the nectar. This type of product promotes the consumption of fruits and vegetables in processed foods of frequent use such as nectars.

Elaboración artesanal de un muffin de zapallo-brócoli y su evaluación de la expectativa y aceptabilidad en el hogar / Homemade cooking of a pumpkin-broccoli muffin and analysis of sensory expectation and acceptability in home use test

Introducción: considerando la importancia de la alimentación saludable, la tendencia de la población de ingerir alimentos prácticos y la oportunidad de incorporar hortalizas a productos alimenticios, surge la propuesta de desarrollar un muffin diferente. Objetivos: desarrollar un muffin de zapallo-brócoli artesanal. Evaluar expectativa y aceptabilidad sensorial en el hogar. Determinar el orden de preferencia del color del plato para servirlo. Materiales y método: se desarrolló el producto alimenticio.124 participantes evaluaron expectativa sensorial (apariencia, suavidad bucal y sabor), percepción de producto saludable e intención de consumo en escala de 1(me disgusta mucho) a 10(me gusta mucho) y orden de preferencia para servir el Muffin, según el color de plato (blanco, verde, azul y rojo). En aceptabilidad en el hogar, 41 personas de las 124 que evaluaron expectativa, realizaron el Muffin según la receta entregada. Evaluaron apariencia, suavidad bucal, sabor, intención de consumo y percepción de producto saludable en escala de 1(me disgusta mucho) a 10(me gusta mucho), disposición a consumir nuevamente este producto y en qué momento del día. Resultados: el producto desarrollado vehiculiza 26,5% de la recomendación de hortalizas por porción. En la expectativa sensorial se obtuvieron muy buenos puntajes promedios, superiores a 7,27. El orden de preferencia del color de los platos para el servicio fue: blanco-verde-rojo-azul; sin diferencias entre rojo-azul. Para la aceptabilidad en el hogar, los atributos evaluados tuvieron valores promedio superiores a 8,5 puntos. El 92,7% de los encuestados consumiría nuevamente el producto, el almuerzo fue el momento del día más elegido. Al comparar las respuestas de expectativa y aceptabilidad (n=41) se encontraron diferencias significativas para suavidad bucal y sabor (valores mayores en aceptabilidad en el hogar). Conclusiones: el muffin de zapallo-brócoli obtuvo muy buenos valores de expectativa y aceptabilidad en el hogar, y contribuiría a alcanzar la recomendación diaria de hortalizas(AU).

Introduction: taking into consideration the importance of healthy eating, the general trend towards easy-to-eat food, and the opportunity to include vegetables in food products triggered off the idea of developing a different, original muffin recipe. Objectives: develop a recipe for a homemade pumpkin & broccoli muffin. Analyze sensory expectation and acceptability in home use test. Determine the order of preference for the color of the plate on which the muffin is served. Materials and Methods: the recipe was formulated, and the food product was prepared. 124 participants provided their input on sensory expectation (appearance, smoothness and flavor), product healthiness perception and intention to eat the muffin, using a 10-point scale (1=dislike extremely and 10=like extremely). They also ranked the colors (white, green, blue and red) of the plate on which the muffin was served in order of preference. 41 of the 124 people that participated in the sensory expectation evaluation homebaked the muffin following the recipe provided and measured acceptability. They assessed appearance, smoothness, flavor, product healthiness perception and intention to eat the muffin using a10-point scale (1=dislike extremely and 10=like extremely). Furthermore, the participants specified their degree of willingness to consume the food product again and what meal they would eat the muffin in. Results: this food product offers 26.5% of the recommended vegetables serving size. Scale scores for sensory expectation were very good, averaging over 7.27. The order of preference for the color of the plate on which the muffin is served was: white-green-red-blue; with no statistical differences between red and blue. The mean scores for the food attributes (acceptability in home used test) were over 8.5. Also, 92.7% of the participants said they would consume the food product again, lunch being the preferred meal for doing so. When comparing answers for sensory expectation and acceptability (n=41), significant differences were found for smoothness and flavor (scores were higher in acceptability for home use test). Conclusions: the pumpkin & broccoli muffin rated very well in sensory expectation and acceptability in home use test and would contribute to reaching the recommended daily intake of vegetables(AU).

HPV vaccine acceptance is high among adults in Mexico, particularly in people living with HIV / Aceptación de la vacuna contra VPH es alta entre adultos en México, especialmente en personas con VIH

Abstract: Objective. To measure HPV vaccine acceptance in diverse Mexican adult popula­tions, taking into account HIV status. Materials and methods: A total of 1 329 men and women, with and without HIV, participated in one of three intervention studies, offering HPV vaccination, carried out in the states of Morelos, Tlaxcala and Mexico City; either the bivalent (Morelos n=103, Tlaxcala n=127) or quadrivalent HPV-vaccine (Mexico City n=1 099) was offered. Results: HPV vaccine was accepted by 80.3% of participants; acceptance was higher in people living with HIV than those without (84.4 vs. 78%, p=0.004). Women had greater HPV infection knowledge (p<0.0001) than men and slightly higher (p=0.4) vaccine acceptance. The main reason for vaccine non-acceptance among HIV-positive participants was their doctor recommended they not get vaccinated. Conclusion: Acceptance of HPV-vaccine was high in men and women regardless of HIV status. Even higher rates of acceptability may be achieved by educating healthcare providers to recommend HPV vaccine to their patients.

Resumen: Objetivo. Medir la aceptación de la vacuna de VPH en una muestra diversa de población adulta mexicana, teniendo en cuenta su estado de VIH. Material y métodos: 1 329 hombres y mujeres con y sin VIH participaron en tres estudios de intervención, realizados en los estados de Morelos, Tlaxcala y Ciudad de México. Se ofreció la vacuna bivalente (Morelos n=103, Tlaxcala n=127) o la cuadrivalente (Ciudad de México n=1 099) contra VPH. Resultados: La vacuna fue aceptada por 80.3% de los participantes; la aceptación fue mayor en personas que viven con VIH que en aquéllas que no (84.4 vs. 78%, p=0.004). Las mujeres (p<0.0001) tenían mayor conocimientos sobre VPH que los hombres y una aceptación de la vacuna ligeramente mayor (p=0.4). El motivo principal de la no aceptación de la vacuna entre personas con VIH fue que su médico recomendó que no se vacunaran. Conclusión: La aceptación de la vacuna contra el VPH fue alta en hombres y mujeres, independientemente del estado de VIH. Se pueden lograr mayores tasas de aceptabilidad educando a los proveedores de atención médica para que recomienden la vacuna contra el VPH a sus pacientes.