Learning to make informed health choices : Protocol for a pilot study in schools in Barcelona

The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain)

Senda Darwin Biological Station: Long-term ecological research at the interface between science and society

Indexación: Web of Science; Scielo.La Estación Biológica Senda Darwin (EBSD) constituye un centro de investigación inmerso en el paisaje rural del norte de la Isla de Chiloé (42º S), donde fragmentos del bosque siempreverde original coexisten con praderas de uso ganadero, turberas de Sphagnum, matorrales sucesionales, plantaciones de Eucalyptus y otras formaciones de origen antropogénico. Desde 1994 hemos realizado estudios de largo plazo centrados en algunas especies de plantas (e.g., Pilgerodendron uviferum D. Don) y animales (e.g., Aphrastura spinicauda Gmelin, Dromiciops gliroides [Thomas]) catalogados como amenazados o escasamente conocidos y en ecosistemas nativos de importancia regional y global (e.g., turberas de Sphagnum, bosque Valdiviano y Nordpatagónico). Las investigaciones han considerado las respuestas de las especies y de los ecosistemas frente al cambio antropogénico del paisaje y cambio climático, así como los efectos de diferentes formas de manejo. Este escenario es semejante al de otras regiones de Chile y Latinoamérica lo que da generalidad a nuestros resultados y modelos. En este período, investigadores asociados a la EBSD han producido más de un centenar de publicaciones en revistas nacionales e internacionales y 30 tesis de pre y postgrado. Entendiendo el papel clave de los seres humanos en los procesos ecológicos de la zona rural, la EBSD ha desarrollado un programa de educación ecológica y vinculación del avance científico con la sociedad local y nacional. La integración de la EBSD a la naciente red de Sitios de Estudios Socio-Ecológicos de Largo Plazo en Chile consolidará y fortalecerá la investigación básica y aplicada que realizamos para proyectarla hacia la siguiente década.Senda Darwin Biological Station (SDBS) is a field research center immersed in the rural landscape of northern Chiloé island (42º S), where remnant patches of the original evergreen forests coexist with open pastures, secondary successional shrublands, Sphagnum bogs, Eucalyptus plantations and other anthropogenic cover types, constituting an agricultural frontier similar to other regions in Chile and Latin America. Since 1994, we have conducted long-term research on selected species of plants (e.g., Pilgerodendron uviferum) and animals (e.g., Aphrastura spinicauda, Dromiciops glirioides) that are considered threatened, poorly known or important for their ecological functions in local ecosystems, and on ecosystems of regional and global relevance (e.g., Sphagnum bogs, North Patagonian and Valdivian rain forests). Research has assessed the responses of species and ecosystems to anthropogenic land-use change, climate change, and the impact of management. During this period, more than 100 scientific publications in national and international journals, and 30 theses (graduate and undergraduate) have been produced by scientists and students associated with SDBS. Because of our understanding of the key role that humans play in ecological processes at this agricultural frontier, since the establishment of SDBS we have been committed to creative research on the communication of science to society and ecological education. The integration of SDBS to the nascent Chilean network of long-term socio-ecological research will consolidate and strengthen basic and applied research to project our work into the next decade.http://ref.scielo.org/vbm4r

The Role of Purported Mucoprotectants in Dealing with Irritable Bowel Syndrome, Functional Diarrhea, and Other Chronic Diarrheal Disorders in Adults

Chronic diarrhea is a frequent presenting symptom, both in primary care medicine and in specialized gastroenterology units. It is estimated that more than 5% of the global population suffers from chronic diarrhea. and that about 40% of these subjects are older than 60 years. The clinician is frequently faced with the need to decide which is the best therapeutic approach for these patients. While the origin of chronic diarrhea is diverse, impairment of intestinal barrier function, dysbiosis. and mucosal micro-inflammation are being increasingly recognized as underlying phenomena characterizing a variety of chronic diarrheal diseases. In addition to current pharmacological therapies, there is growing interest in alternative products such as mucoprotectants, which form a mucoadhesive film over the epithelium to reduce and protect against the development of altered intestinal permeability, dysbiosis, and mucosal micro-inflammation. This manuscript focuses on chronic diarrhea in adults, and we will review recent evidence on the ability of these natural compounds to improve symptoms associated with chronic diarrhea and to exert protective effects for the intestinal barrier

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Comparing Blend of Essential Oils Plus 25-Hydroxy-Vit-D3 Versus Monensin Plus Virginiamycin Combination in Finishing Feedlot Cattle: Growth Performance, Dietary Energetics, and Carcass Traits.

Ninety crossbreed bulls (349.5 ± 8.25 kg initial weight) were used in an 87day trial to compare the effects of a blend of essential oils plus 25-hydroxy-Vit-D3 (EO + HyD) versus the combination of monensin with virginiamycin (MON + VM) on feedlot growth performance and carcass characteristics. Dietary treatments (nine replicates/treatment) were supplemented with 40 mg/kg diet dry matter of MON + VM (equal parts) or with 120.12 mg/kg diet dry matter of a combination of standardized mixture of essential oils (120 mg) plus 0.12 mg of 25-hydroxy-vitamin-D3 (EO + HyD). There were no treatment effects on dry matter intake (DMI, p = 0.63). However, the coefficient of variation in day-to-day DMI was greater for EO + HyD than for MON + VM (11.4% vs. 3.88%, p = 0.04). There were no treatment effects (p ≥ 0.17) on daily weight gain, gain-to-feed ratio, and estimated dietary net energy. Cattle supplemented with EO + HyD had greater Longissimus muscle area (7.9%, p &lt; 0.01) and estimated retail yield (1.6%, p = 0.03), and tended to have heavier (1.7%, p = 0.10) carcass weight. Differences among treatments in dressing percentage, fat thickness, kidney-pelvic-heart fat, and marbling score were not appreciable (p &gt; 0.10). It is concluded that growth performance response and dietary energetic are similar for finishing cattle supplemented with EO + HyD vs. MON + VM. However, compared with MON + VM, supplementation with EO + HyD during the finishing phase may improve carcass Longissimus area and carcass yield

The Effects of Single or Combined Supplementation of Probiotics and Prebiotics on Growth Performance, Dietary Energetics, Carcass Traits, and Visceral Mass in Lambs Finished under Subtropical Climate Conditions

The aim of this trial was to test the effects of the use of eubiotics (pro- and prebiotics) alone or in combination in the diet of lambs finished under subtropical climate conditions. For this purpose, 40 Pelibuey × Katahdin lambs (29.5 ± 4.8 kg initial live weight) were used in a 93 day growth-performance experiment. Dietary treatments consisted of a cracked corn-based finishing diet supplemented with (1) no eubiotics (control), (2) 3 g of probiotics (live Saccharomyces cerevisiae, SC), (3) 3 g of prebiotics (mannan oligosaccharide plus b-glucans, MOS), and (4) a combination of 1.5 g of SC and 1.5 g of MOS (SC+MOS). Throughout the study, the average temperature humidity index (THI) was 78.60. Compared to controls, supplementation with SC or MOS, alone did not affect average daily gain (ADG), but enhanced feed efficiency by 5.6% and 6.9% (gain-to-feed ratio, G:F) and dietary net energy by 4.6% and 5.9%, respectively. Compared to controls, SC+MOS enhanced ADG (10%), G:F (9.5%), and dietary net energy (7.2%). Lambs fed SC+MOS had also greater ADG, G:F, and dietary net energy compared to lambs fed SC alone. When compared to MOS, the combination enhanced ADG (10.4%, p = 0.04). This effect could be attributed to the increased dry matter intake (7.6%, p = 0.06), as neither G:F nor dietary energy was significantly affected. Compared with controls and SC, supplementation with MOS alone and SC+MOS increased kidney–pelvic–heart fat, while SC supplementation tended (p = 0.08) to reduce 4.1% the relative intestinal mass (as a proportion of empty body weight) when compared to controls. Treatment effects on the other carcass measures were not significant. In the present study, supplemental probiotics and/or prebiotics improved dietary energetic efficiency in lambs finished under subtropical climatic conditions. The combination of probiotics with prebiotics reinforced this positive effect