Occurrence and inequalities by education in multimorbidity in Brazilian adults between 2013 and 2019: evidence from the National Health Survey.

OBJECTIVE: The aims of this study were: 1) to estimate the prevalence of multimorbidity in 2013 and 2019 in adults aged 20-59 years; 2) to assess inequalities in the prevalence of multimorbidity in 2013 and 2019 according to educational level. METHODS: Data from two cross-sectional surveys from the Brazilian National Health Survey in 2013 and 2019 were used. Multimorbidity was assessed from 14 lifetime self-reported morbidities (except back problems) and defined using the cutoff point of ≥2 diseases. The prevalence of multimorbidity and individual morbidities were described according to gender, age, skin color, and education. For education, crude, and relative inequalities in prevalence of multimorbidity were calculated using the Slope Index of Inequality and the Concentration Index, respectively. RESULTS: The prevalence of multimorbidity increased from 18.7% (95%CI 18.0-19.3) in 2013 to 22.3% (95%CI 21.7-22.9) in 2019, being higher among women and adults between 30-59 years in both periods. Asthma/bronchitis, depression, and back problems were the conditions that increased the most in the study period. Absolute and relative inequalities by education status were observed in the study period, with worse multimorbidity profiles among the less educated. CONCLUSION: The prevalence of multimorbidity increased between 2013 and 2019. Inequalities in the prevalence of multimorbidity were observed according to educational level

Soy Niña

Este libro pretende contribuir al reencuentro de la educación con esas finalidades que verdaderamente importan a una niña o un niño: ser feliz, jugar, vivir juntos y (no) aprender. Para ello hemos puesto el arte, nuestras experiencias y el saber acumulado al servicio del disfrute, el cuestionamiento, el análisis crítico y la construcción común de un presente deseable. Un texto colaborativo coordinado por Ignacio Calderón Almendros y realizado por alumnado de Educación y Cambio Social en el Grado en Educación Infantil de la Universidad de Málaga

Monogeneos, parásitos de peces en México: estudio recapitulativo

Aquaculture has always been considered a very important activity although serious problems have restricted its development in Mexico. Parasitic conditions can affect product quality and result in severe cases in a complete loss of profitability. Among helminths, monogeneans is the group most commonly found in Mexican fish farms and cause considerable damage and high mortality rates in different production systems. Monogeneans in Mexico are represented by several species of economic importance showing both high host specificity and prevalence, thus constituting a potential risk for intensive fish culture in the tropics and subtropics. For instance, tilapia that can be considered one of the most important economic fresh water fishery resources in the country, accounts for 50 % of all Mexican aquaculture output, while carp production plays an important social and economic role in rural communities. Although monogeneans cause great economic losses, there is scant information on them in Mexico. The present review seeks to provide the most relevant information regarding epidemiological aspects, economic impact, species abundance and distribution across Mexico, as well as host signals and symptoms for a practical diagnosis of these parasitic diseases, factors which promote their increase and expansion, and lastly, alternative methods for prevention and control.No obstante la importancia económica de la acuacultura, existen serias limitantes que frenan su crecimiento, destacando entre ellas las parasitosis, que en afecciones severas además de demeritar la calidad del producto, son capaces de anular la rentabilidad del cultivo. Dentro de los helmintos, los monogeneos ocasionan considerables daños, con altas mortalidades en los diferentes sistemas de producción empleados en acuacultura. En México, los monogeneos están representados por varias especies importantes económicamente, con una marcada especificidad hospedatoria y prevalencias elevadas, por lo que representan un peligro potencial para el cultivo intensivo de tilapia y carpa en aguas tropicales y semitropicales. La tilapia es el recurso pesquero más importante en las aguas dulces del país, su producción anual contribuye con el 50 % de la producción total que se obtiene por acuacultura, mientras que la carpa, juega un papel relevante por el impacto social y económico en el medio rural mexicano. Los monogeneos ocasionan cuantiosos daños y diversas pérdidas económicas en las pesquerías. En el presente estudio se proporciona información relativa a su epidemiología, impacto económico, abundancia y distribución en los diferentes estados de la República Mexicana. Por otra parte, se describen los signos que ocasionan en sus huéspedes, los factores que favorecen su desarrollo y dispersión, así como la forma de prevenirlos y la metodología que se debe emplear en su tratamiento y control

Variación estacional de dactylogyrus sp. en dos unidades productoras de tilapia del estado de Morelos

En los centros acuícolas de Zacatepec y EI Rodeo Morelos, SEPESCA, se realizó un estudio con objeto de conocer la variación estacional de Dactylogyrus sp. así como la especie de pez, talla, sexo, temperatura y época del año en que se desarrolla el tremá

Frecuencia de nemátodos gastroentéricos en bovinos de tres áreas de clima subtropical húmedo de México

The genera and species of bovine gastrointestinal (GI) nematodes were recorded from 1995 to 1997 throughout four seasons, in three different humid, wet, subtropical locations, i.e.: Sauta, Medellin, and Tizimin (Mexico's states of Nayarit, Veracruz, and Yucatan, respectively). In each location, five freshly weaned, GI nematode-free calves were placed on grasslands, during four time periods. Placements were performed as follows: a) mid raining season (August), b) late raining season (November), c) early dry season (February), and d) early raining season (June). After a 30-day, free-range period cattle were slaughter and adult GI nematodes were collected and identified. Means and standard deviations of nematode species were as follows: Sauta, Haemonchus contortus 32+-8, 615+-115, 267+-87, and 20+-4, Bunostomum phlebotomum: 5+-1, 2+-2, 2+-2, and 0, Oesophagostomum radiatum: 84+-22, 46+-21, 76+-39, and 22+-14, and Trichuris ovis 8+-1, 104+-21, 92+-35, and 112+-38, Medellin, H. contortus 326+-152, 613+-210, 1167+-387, and 12+-8, H. similis: 30+-21, 56+-22, 35+-16, and 0, Cooperia punctata: 320+-185, 414+-409, 47+-28, and 0+-0, B. phlebotomum: 10+-7, 2+-2, 5+-2, and 0, O. radiatum: 106+-42, 228+-61, 72+-39, and 228+-144, Tizimin, H. contortus: 160+-58, 440+-380, 1514+-718, and 300+-184, C. punctata: 46+-31, 90+-84, 930+-1180, and 55+-34, O. radiatum: 4+-4, 26+-33, 0, and 7+-7, for the animals placed in August, November, February, and June, respectively. Significant differences (PSe registraron los géneros y especies de nemátodos gastroentéricos de bovinos de 1995 a 1997, durante cuatro épocas climáticas, en tres lugares con clima tropical subhúmedo cálido: Sauta, Nayarit, Medellín, Veracruz y Tizimín, Yucatán. En cada uno de estos y durante cuatro ocasiones se introdujeron en un potrero cinco becerros recién destetados, libres de nemátodos gastroentéricos. La primera introducción se realizó durante la temporada de lluvias (agosto), la segunda durante la temporada de nortes (noviembre), la tercera al término de nortes (febrero) y la última, al inicio de las lluvias (junio). Después de 30 días de libre pastoreo, los animales fueron sacrificados para la recuperación e identificación de los nemátodos gastrointestinales adultos. La media y desviación estándar de las especies identificadas fueron: en Sauta, Haemonchus contortus 32±8, 615±115, 267±87 y 20±4, Bunostomum phlebotomum: 5±1, 2±2, 2±2 y negativo, Oesophagostomum radiatum: 84±22, 46±21, 76±39 y 22±14 y Trichuris ovis 8±1, 104±21, 92±35 y 112±38, En Medellín, H. contortus 326±152, 613±210, 1167±387 y 12±8, H. similis: 30±21, 56±22, 35±16 y negativo, Cooperia punctata: 320±185, 414±409, 47±28 y 0±0, B. phlebotomum: 10±7, 2±2, 5±2 y negativo, O. radiatum: 106±42, 228±61, 72±39 y 228±144. En Tizimín, H. contortus: 160±58, 440±380, 1514±718 y 300±184, C. punctata: 46±31, 90±84, 930±1180, 55±34, O. radiatum: 4±4, 26±33, negativo, 7±7, para los animales pastoreados en agosto, noviembre, febrero y junio en cada uno de los lugares respectivamente. Se encontró diferencia en los tres sitios en estudio (

Extracting fuzzy rules from polysomnographic recordings for infant sleep classification

A neuro-fuzzy classifier (NFC) of sleep-wake states and stages has been developed for healthy infants of ages 6 mo and onward. The NFC takes five input patterns previously identified on 20-s epochs from polysomnographic recordings and assigns them to one out of five possible classes: Wakefulness, REM-Sleep, Non-REM Sleep Stage 1, Stage 2, and Stage 3-4. The definite criterion for a sleep state or stage to be established is duration of at least 1 min. The data set consisted of a total of 14 continuous recordings of naturally occurring naps (average duration: 143 39 min), corresponding to a total of 6021 epochs. They were divided in a training, a validation and a test get with 7, 2, and 5 recordings, respectively. During supervised training, the system determined the fuzzy concepts associated to the inputs and the rules required for performing the classification, extracting knowledge from the training set, and pruning nonrelevant rules. Results on an independent test set achieved 83.9 +/- 0.4% of expert agreement. The fuzzy rules obtained from the training examples without a priori information showed a high level of coincidence with the crisp rules stated by the experts, which are based on internationally accepted criteria. These results show that the NFC can be a valuable tool for implementing an automated sleep-wake classification system

3er. Coloquio: Fortalecimiento de los Colectivos de Docencia

Las memorias del 3er. Coloquio de Fortalecimiento de Colectivos de Docencia deben ser entendidas como un esfuerzo colectivo de la comunidad de académicos de la División de Ciencias y Artes para el Diseño, en medio de la pandemia COVID-19, con el fin de: • Analizar y proponer acciones concretas que promuevan el mejoramiento de la calidad docente en la División. • Proponer acciones que permitan continuar fortaleciendo los cursos con modalidad a distancia (remotos). • Ante un escenario que probablemente demandará en el mediano plazo, transitar del modelo remoto a un modelo híbrido, proponer acciones a considerar para la transición de los cursos. • Planear y preparar cursos de nivelación de conocimientos, para cuando se transite a la impartición de la docencia de manera mixta o presencial, dirigidos a los alumnos que no hayan tenido oportunidad de desarrollar actividades relevantes para su formación, como prácticas de talleres y laboratorios, visitas, o alguna otra actividad relevante

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit