Consideraciones ante una eventual regularización del cannabis recreativo en Colombia

Seminario InternacionalEl marco jurídico en relación al uso recreativo y médico del cannabis varía mucho según el país y la región, pero sigue estando prohibido en gran medida a nivel internacional. Los defensores a favor de medidas regulativas, han enfatizado el potencial para erradicar el mercado negro del cannabis, mejorar el control de su calidad, aumentar los ingresos fiscales, mejorar la disponibilidad de cannabis medicinal y reducir la violencia relacionada con las pandillas y carteles que trafican con drogas.1. INTRODUCCIÓN 2. DESARROLLO 3. CONCLUSIONES 4. BIBLIOGRAFÍAPregradoEconomist

Appropriateness of the probability approach with a nutrient status biomarker to assess population inadequacy: a study using vitamin D

Background: There are questions about the appropriate method for the accurate estimation of the population prevalence of nutrient inadequacy on the basis of a biomarker of nutrient status (BNS). Objective: We determined the applicability of a statistical probability method to a BNS, specifically serum 25-hydroxyvitamin D [25(OH)D]. The ability to meet required statistical assumptions was the central focus. Design: Data on serum 25(OH)D concentrations in adults aged 19–70 y from the 2005–2006 NHANES were used (n = 3871). An Institute of Medicine report provided reference values. We analyzed key assumptions of symmetry, differences in variance, and the independence of distributions. We also corrected observed distributions for within-person variability (WPV). Estimates of vitamin D inadequacy were determined. Results:We showed that the BNS [serum 25(OH)D] met the criteria to use the method for the estimation of the prevalence of inadequacy. The difference between observations corrected compared with uncorrected for WPV was small for serum 25(OH)D but, nonetheless, showed enhanced accuracy because of correction. The method estimated a 19% prevalence of inadequacy in this sample, whereas misclassification inherent in the use of the more traditional 97.5th percentile high-end cutoff inflated the prevalence of inadequacy (36%). Conclusions: When the prevalence of nutrient inadequacy for a population is estimated by using serum 25(OH)D as an example of a BNS, a statistical probability method is appropriate and more accurate in comparison with a high-end cutoff. Contrary to a common misunderstanding, the method does not overlook segments of the population. The accuracy of population estimates of inadequacy is enhanced by the correction of observed measures for WPV

Dietary Iron bioavailability: A simple model that can be used to derive country-specific dietary reference values for adult men and women

Background: Reference intakes for iron are derived from physiological requirements, with an assumed value for dietary iron absorption. A new approach to estimate iron bioavailability, calculated from iron intake, status, and requirements was used to set European dietary reference values, but the values obtained cannot be used for low- and middle-income countries where diets are very different. Objective: We aimed to test the feasibility of using the model developed from United Kingdom and Irish data to derive a value for dietary iron bioavailability in an African country, using data collected from women of child-bearing age in Benin. We also compared the effect of using estimates of iron losses made in the 1960s with more recent data for whole body iron losses. Methods: Dietary iron intake and serum ferritin (SF), together with physiological requirements of iron, were entered into the predictive model to estimate percentage iron absorption from the diet at different levels of iron status. Results: The results obtained from the 2 different methods for calculating physiological iron requirements were similar, except at low SF concentrations. At a SF value of 30 µg/L predicted iron absorption from the African maize-based diet was 6%, compared with 18% from a Western diet, and it remained low until the SF fell below 25 µg/L. Conclusions: We used the model to estimate percentage dietary iron absorption in 30 Beninese women. The predicted values agreed with results from earlier single meal isotope studies; therefore, we conclude that the model has potential for estimating dietary iron bioavailability in men and nonpregnant women consuming different diets in other countries

Differences in use of electronic nicotine delivery systems by smoking status and demographic characteristics among Australian young adults

Issue addressed: Electronic nicotine delivery systems (ENDS) continue to grow in popularity, particularly among young adults. Understanding by whom various ENDS are being used and why within this population segment can assist the development of appropriate interventions targeting those most vulnerable to use and inform policy decisions in this area. Accordingly, this study assessed the demographic characteristics associated with ENDS use among Australian young adults, and reasons for current e-cigarette use. Methods: An online survey was administered to 1116 Australians aged 18-25 years (59% female). Results: Smokers were more likely than non-smokers to report (a) ever use of ENDS (67% vs 28%), (b) ever use of an e-cigarette (64% vs 24%), e-cigar (17% vs 8%) or e-hookah (15% vs 8%) and (c) current use of e-cigarettes (19% vs 6%). Male smokers were more likely than female smokers to be current e-cigarette users. The most common reason for current e-cigarette use was enjoyment. Conclusions: Young male adults appear to be particularly vulnerable to becoming regular e-cigarette users. This demographic group may need to be a primary focus of prevention and intervention efforts. Contrary to popular belief, smoking cessation was not a primary reason for e-cigarette use. So what?: Greater efforts are needed to educate young adults on the harms associated with ENDS use, especially if use is being driven by the perception that they are a harmless means of amusement. Maintaining existing regulations limiting the accessibility of these products is crucial to ensuring widespread use is minimised

Veterans Justice Programs: Assessing Population Risks for Suicide Deaths and Attempts

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156471/2/sltb12631_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156471/1/sltb12631.pd

A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents

© The British Dietetic Association Ltd. This is the peer reviewed version of 'Chima, L., Mulrooney, H. M., Warren, J., & Madden, A. (2020). A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents. Journal of Human Nutrition and Dietetics. https://doi.org/10.1111/jhn.12735'. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Background:  Resting energy expenditure (REE) estimate sare often needed in young people and can be predicted using prediction equations based on body weight.  However,these equations may perform poorly in obesity and overweight. The aim of this systematic review was to identify equations based on simple anthropometric and demographic variables which provide the most accurate and precise estimates of REE in healthy obese and overweight young people. Methodology:Systematic searches for relevant studies in healthy obese and overweight young people aged ≤18 years were undertaken using PubMed, Scopus, Cinahl, OpenGrey and Cochrane Library (completed January 2018). Search terms included metabolism, calorimetry, obesity and prediction equation. Data extraction,study appraisal and synthesis followed PRISMA guidelines. Results:From 390 screened titles, 13 studies met inclusion criteria. The most accurate REE predictions (least biased) were provided by Schofield equations (+0.8%[3-18 years]; 0% [11-18 years]; +1.1% [3-10 years]). The most precise REE estimations (percentage of predictions ±10% of measured) for 11-18 years were provided by Mifflin equations (62%), and for 7-18 years by the equations of Schmelzle (57%), Henry (56%) and Harris Benedict (54%). Precision of Schofield predictions was 43% in both age groups. No accuracy data were available for those <3 years or for precision for those <7 years. Principal conclusions: No single equation provided accurate and precise REE estimations in this population.  Schofield equations provided the most accurate REE predictions so are useful for groups.  Mifflin equations provided the most precise estimates for individuals aged 11-18 but tended to underestimate REE.  Peer reviewedFinal Accepted Versio

The current state of hospital-based emergency medicine in Germany

Germany has a long tradition of having physicians, often anesthesiologists with additional training in emergency medicine, deliver prehospital emergency care. Hospital-based emergency medicine in Germany also differs significantly from the Anglo-American model, and until recently having separate emergency rooms for different departments was the norm. In the past decade, many hospitals have created “centralized emergency departments” [Zentrale Notaufnahme (ZNAs)]. There is ongoing debate about the training and certification of physicians working in the ZNAs and whether Germany will adopt a specialty board certification for emergency medicine

Prediction of winter vitamin D status and requirements in the UK population based on 25(OH) vitamin D half-life and dietary intake data

On a population basis, there is a gradual decline in vitamin D status (plasma 25(OH)D) throughout winter. We developed a mathematical model to predict the population winter plasma 25(OH)D concentration longitudinally, using age-specific values for 25(OH)D expenditure (25(OH)D3t1/2), cross-sectional plasma 25(OH)D concentration and vitamin D intake (VDI) data from older (70+ years; n=492) and younger adults (18-69 years; n=448) participating in the UK National Diet and Nutrition Survey. From this model, the population VDI required to maintain the mean plasma 25(OH)D at a set concentration can be derived. As expected, both predicted and measured population 25(OH)D (mean (95%CI)) progressively declined from September to March (from 51 (40-61) to 38 (36-41)nmol/L (predicted) vs 38 (27-48)nmol/L (measured) in older people and from 59 (54-65) to 34 (31-37)nmol/L (predicted) vs 37 (31-44)nmol/L (measured) in younger people). The predicted and measured mean values closely matched. The predicted VDIs required to maintain mean winter plasma 25(OH)D at 50nmol/L at the population level were 10 (0-20) to 11 (9-14) and 11 (6-16) to 13(11-16)μg/d for older and younger adults, respectively dependent on the month. In conclusion, a prediction model accounting for 25(OH)D3t1/2, VDI and scaling factor for the 25(OH)D response to VDI, closely predicts measured population winter values. Refinements of this model may include specific scaling factors accounting for the 25(OH)D response at different VDIs and as influenced by body composition and specific values for 25(OH)D3 t1/2 dependent on host factors such as kidney function. This model may help to reduce the need for longitudinal measurements