Access and use of health care services by mothers and children in the Texas-Mexico border region: preliminary findings from the 2006 Rio Grande Valley health survey

Background: Latino/a children have the highest rate of uninsurance among all ethnic/racial groups. There is some evidence that patterns of health care use between parents and their children are interrelated. Children are also more likely to have health insurance coverage if their parents are insured but public insurance programs do not cover all parents of participating children. The objective of this study was to assess whether there is a relation between patterns of health care utilization between Latina mothers and their children who reside in the South Texas- Mexico border region. Survey data on 495 Latina women with children from the 2006 Rio Grande Valley Health Survey were used to estimate bivariate probit models of the determinants of five health care access and utilization indicators. Patterns of health care utilization between Latina mothers and their children were positively related for having a usual place of care, visiting a doctor, visiting an emergency room, and having delayed health care needed. Both desirable and undesirable parental and child health care access/utilization patterns for Latinos/as are interrelated. Interventions that promote good health care utilization behavior for Latina mothers seem to spillover to their children. Public health insurance programs that focus on covering uninsured children but leave their parents uninsured may end up not taking full advantage of the positive spillover effects of health care access/utilization from mothers to their children

Complementary and Alternative Medicine: Personal Preference or low Cost Option?

From acupuncture to yoga, Americans’ use of complementary and alternative medicine (CAM) is widespread and growing. The reasons that people give for using CAM are as diverse as the CAM therapies themselves: some perceive that conventional health care is ineffective, while others consider CAM to be more consistent with their own values and beliefs about health. As conventional health care costs rise, it is also possible that some people turn to CAM as a low cost alternative. This Issue Brief summarizes research that evaluates the relationship between CAM use and perceived access to conventional health care

Investigación cualitativa en educación: reexaminando sus teorías, prácticas y desarrollos en una era científico-política

Since it entered education in the mid-20th century, qualitative research has been a well-established methodology among educational researchers. Its strength lies in its nature, scope, and methodological flexibility to understand education's cultural, social, political and moral phenomena. Between the 1970s and 1980s, the relevance and superiority of quantitative vs. qualitative research in education were debated in academic forums. The paradigm debate was so intense that it reached political discussions. In 2002, the National Research Council (NRC) of the United States of America recommended the Federal Department of Education the exclusion of qualitative research from federal funds because it was not considered scientific research. A similar situation was observed in England and Australia. Since then, qualitative research has continued to develop as a model of educational research with the support of private funds. This paper revisits qualitative education research and examines its developments to reposition itself as a legitimate model of scholarly research in a political-scientific era.Desde su aparición en la educación a mediados del siglo XX, la investigación cualitativa ha sido una metodología plenamente asentada entre los investigadores de la educación. Su principal valor reside en su naturaleza, alcance y flexibilidad metodológica, que permite comprender los fenómenos culturales, sociales, políticos y éticos de la educación. Entre los años setenta y ochenta del siglo XX fue muy debatido en los foros académicos la idoneidad y superioridad de la investigación cuantitativa frente a la cualitativa en el mundo educativo. La polémica sobre los paradigmas fue tan intenso que llegó incluso a los debates políticos. En 2002, el National Research Council (NRC) de los Estados Unidos recomendó al Federal Department of Education la exclusión de la investigación cualitativa de cualquier asignación de fondos federales al no considerarla dentro del concpeto de investigación científica. Una situación similar ocurrió en Reino Unido y Australia. Desde entonces, la investigación cualitativa ha continuado desarrollándose como modelo de investigación educativa, pero únicamente con el apoyo de fondos privados. Este artículo revisa la situación actual de la investigación educativa cualitativa y examina su evolución con el fin de reposicionarla como un modelo legítimo de investigación académica en una era político-científica

El quiste óseo aneurismático en niños y adolescentes

Desde el año 1981 hasta el año 1996 hemos tratado en nuestro servicio un total de 12 pacientes con diagnóstico de Quiste Óseo Aneurismático (QOA). Esta entidad clínico-patológica continúa hoy teniendo un origen incierto que en la mayoría de las ocasiones no puede reconocerse. Los tratamientos empleados fueron: legrado e injerto óseo en siete casos, resección en bloque en tres casos, y en 2 casos tratamiento expectante. Los resultados del tratamiento quirúrgico fueron satisfactorios en el 75% de los casos, encontrando un 25% de recidivas, que ocurrieron en los pacientes más jóvenes con quistes más agresivos. El tiempo medio de seguimiento fue de 4 años (mínimo 1 - máximo 8). Realizamos en el trabajo, además, una comparación con otros métodos de tratamiento publicados como son la crioterapia intratumoral y la embolizacón arterial selectiva, los cuales encontramos de utilidad relativa ya que requieren una alta especialización y una selección precisa de los casos. También la radioterapia que tiene una utilidad restringida a aquellos casos de inaccesibilidad operatoria.From 1981 to 1996 twelve patients were treated in our orthopaedic department with the diagnosis of Aneurismal Bone Cyst (ABC). This pathologic and clinical entity has an unknown etiology that in the majority of cases it can¿t be elucidated. The threatment was: curettage and bone graft in seven cases; in bloc excision in three cases and expectant in two. Surgical treatment results were satisfactory in 75% of cases, with 25% of local recurrences that took place in younger patients with more aggressive cysts. Mean follow-up was four years (range: 1-8). In this study we make a comparison with other methods of treatment reported like intratumoral criotherapy and selective arterial embolization. We find these methods of relative utility due to their high level of orthopaedist specialization and precise selection of cases. The radiotherapy has restricted application to cases of unresectable tumours

Enmiendas orgánicas y sus efectos en las propiedades físicas y biológicas de un suelo San Antón

The objective of this work was to measure the effects of repeated short-term organic amendments that we termed soil treatment management cycles (STMC) on physical and biological properties of a San Antón series soil. Each STMC lasted 60 days and consisted of incorporating 5% organic matter from coffee pulp compost; the planting, growth and incorporation of an intercrop of four green manure species; and the application of mycorrhizae and compost tea. The treatments were labeled: CL0, CL1, CL2 and CL3; where CL0 was the control, CL1 received one STMC, CL2 and CL3 received two and three STMC, respectively. The STMC intended to mimic the overall effect of a sustainable agricultural system, not to measure the individual effects of the practices. All treatments (CL1, CL2, CL3) showed an increase in soil organic matter (p≤0.05). When compared to the CL0 control, saturated hydraulic conductivity increased and bulk density decreased in all soils. Soil macroporosity was significantly increased by CL2 and CL3. Soil aggregate stability increased in CL1, CL2 and CL3 plots. Microbial biomass C increased in treatment CL3, and microbial biomass N increased in CL2 and CL3. The production of stable aggregates was correlated to humic acid content and positively influenced all other physical parameters assessed in this study. The STMC had a positive impact on soil properties by increasing the soil organic matter as well as the humic acid fraction. Soil macroporosity, defined as porosity with radius > 38 µm, was significantly increased by treatments CL2 and CL3. All of the organic matter fractions, including total organic matter, humic acid content, microbial biomass C and microbial biomass N were significantly increased by one or more STMC.Se utilizaron varias prácticas de enmiendas orgánicas en un suelo de la serie San Antón (Mollisol) y se cuantificaron los cambios respectivos en la capacidad física y biológica de este suelo. Al conjunto de estas prácticas le dimos el nombre de manejo de ciclos de tratamiento de suelo (en inglés, soil treatment management cycles o STMC). Cada STMC duró 60 días y consistía en incorporar 5% de materia orgánica proveniente de composta de pulpa de café, la plantación, crecimiento e incorporación de cuatro especies como abono verde y la aplicación de micorrizas, además de té de composta. Los tratamientos fueron: CL0, CL1, CL2 y CL3; donde CL0 fue el control, CL1 tuvo un STMC, CL2 y CL3 tuvieron dos- y tres-STMC, respectivamente. Los STMC se efectuaron con el propósito de asimilar el efecto conjunto de un sistema agrícola sustentable y no con el propósito de medir los efectos individuales de cada práctica. Todos los tratamientos (CL1, CL2 y CL3) resultaron en un aumento en la materia orgánica del suelo (p≤0.05). La conductividad hidráulica saturada aumentó y la densidad del suelo se redujo al compararlo con el CL0 control. La macroporosidad del suelo aumentó significativamente en CL2 y CL3. La estabilidad de agregados del suelo aumentó en CL1, CL2 y CL3. La biomasa microbiana C aumentó en CL3 y la biomasa microbiana N aumentó por CL2 y CL3. La producción de agregados estables del suelo se correlacionó con el contenido de ácidos húmicos y tuvo efectos positivos en todos los demás parámetros físicos observados en este estudio. Los STMC impactaron las propiedades del suelo cambiando la cantidad de materia orgánica, así como la cantidad de ácidos húmicos. La macroporosidad del suelo, definida como la porosidad de radio > 38 µm, incrementó significativamente para los tratamientos CL2 y CL3. Todas las fracciones de materia orgánica, incluyendo la materia orgánica total, contenido de ácidos húmicos, biomasa microbiana C y biomasa microbiana N fueron significativamente superiores con uno o más STMC

Knowledge, Information, and Water Treatment Behavior of Residents in the Kathmandu Valley, Nepal

Access to safe drinking water plays a crucial role in the overall social and economic development of a community. Unsafe water delivered to household taps increases the risks of waterborne diseases and threatens population health. Consumers can adopt a number of averting behaviors such as filtering or boiling their water. While these approaches are effective in reducing the likelihood of contracting a waterborne disease, not all households treat their water. Given this, it is important to develop a better understanding of factors that influence water treatment behavior. In this paper, we examine determinants of water treatment behavior using survey data (N=1200) from Kathmandu, Nepal. In particular, this paper focuses on the impacts of knowledge, exposure to information, and community participation on drinking water treatment behavior. Previous research has found that income, education level, awareness, and exposure to media are major factors that impact the individual-level decision to treat water before using it. We contribute to this literature by explicitly examining how knowledge about waterborne diseases, exposure to water quality information campaigns, and participation in community organizations impact drinking water treatment behavior. The results from probit regression analyses suggest that either a one percentage increase in the knowledge index or community participation index both increase the likelihood of utilizing drinking water treatment methods by about 0.17 percentage points. Households connected to the distribution system are 31 percentage points more likely to treat water compared to those that are not connected to the system. Multinomial results indicate that wealthier households use more than one treatment method

Tratamiento de las fracturas complejas de fémur mediante enclavado intramedular encerrojado de Brooker-Wills

Se realiza un estudio retrospectivo de 19 pacientes con fracturas complejas de fé- mur tratados mediante el clavo bloqueado de Brooker-Wills. La causa más frecuente de dichas fracturas fueron los accidentes de tráfico. Hubo lesiones asociadas en el 63% de los casos. El tiempo medio de seguimiento fue de 27 meses. Nuestros resultados han sido evaluados mediante los criteros de Thorensen, obteniendo un 84% de resultados favorables. Hubo problemas técnicos intraoperatorios en 8 pacientes, la mayoría debidos a la penetración de la cortical femoral distal por una de las aletas. Todas las fracturas consolidaron. La mayor ventaja de este clavo la encontramos en la sencillez del bloqueo distal, lo cual supone una menor exposición a la radiación y un acortamiento del tiempo quirúrgico.A retrospective study of 19 patients with complex fermoral fractures treated with the Brooker-Wills interlocking intramedullary nail is reported. The traffic-accident was the most common cause of these fractures. Associated injuries were found in 63% of cases. The mean time follow-up period was 27 months. Results were assessed according to Thorensen's criteria. We found excellent or good results in 84% of these patients. There were intraoperative technical problems without clinical complications in 8 patients, most of them due to distal femoral cortex penetration with the pins. Union occurred in all fractures. The greatest advantage of this nail comes from the easy insertion of distal pins, providings less exposition to radiation and a shorter operative tim

Fructose metabolism in Chromohalobacter salexigens: interplay between the Embden–Meyerhof–Parnas and Entner–Doudoroff pathways

Background The halophilic bacterium Chromohalobacter salexigens metabolizes glucose exclusively through the Entner–Doudoroff (ED) pathway, an adaptation which results in inefficient growth, with significant carbon overflow, especially at low salinity. Preliminary analysis of C. salexigens genome suggests that fructose metabolism could proceed through the Entner–Doudoroff and Embden–Meyerhof–Parnas (EMP) pathways. In order to thrive at high salinity, this bacterium relies on the biosynthesis and accumulation of ectoines as major compatible solutes. This metabolic pathway imposes a high metabolic burden due to the consumption of a relevant proportion of cellular resources, including both energy molecules (NADPH and ATP) and carbon building blocks. Therefore, the existence of more than one glycolytic pathway with different stoichiometries may be an advantage for C. salexigens. The aim of this work is to experimentally characterize the metabolism of fructose in C. salexigens. Results Fructose metabolism was analyzed using in silico genome analysis, RT-PCR, isotopic labeling, and genetic approaches. During growth on fructose as the sole carbon source, carbon overflow was not observed in a wide range of salt concentrations, and higher biomass yields were reached. We unveiled the initial steps of the two pathways for fructose incorporation and their links to central metabolism. While glucose is metabolized exclusively through the Entner–Doudoroff (ED) pathway, fructose is also partially metabolized by the Embden–Meyerhof–Parnas (EMP) route. Tracking isotopic label from [1-13C] fructose to ectoines revealed that 81% and 19% of the fructose were metabolized through ED and EMP-like routes, respectively. Activities of enzymes from both routes were demonstrated in vitro by 31P-NMR. Genes encoding predicted fructokinase and 1-phosphofructokinase were cloned and the activities of their protein products were confirmed. Importantly, the protein encoded by csal1534 gene functions as fructose bisphosphatase, although it had been annotated previously as pyrophosphate-dependent phosphofructokinase. The gluconeogenic rather than glycolytic role of this enzyme in vivo is in agreement with the lack of 6-phosphofructokinase activity previously described. Conclusions Overall, this study shows that C. salexigens possesses a greater metabolic flexibility for fructose catabolism, the ED and EMP pathways contributing to a fine balancing of energy and biosynthetic demands and, subsequently, to a more efficient metabolism.University of Murcia and University of Seville was supported by projects: BIO2015-63949-R, BIO2014-54411-C2-1-REuropa MINECO/FEDER RTI2018-094393-B-C21Fundación Séneca (Grant no. 19236/PI/14

Plastia sustitutiva del LCA con tendones de la pata de ganso cuadruples

Se han estudiado retrospectivamente 44 casos de pacientes a los que se les realizó por vía artrocóspica una plastia sustitutiva intraticular de reconstrucción del LCA, con tendones de Semitendinoso y Recto Interno antólogos, en 4 fascículos. La edad media de los pacientes fue de 25 años. Los resultados a corto plazo (2 años) obtenidos con KT-1000 a 30 Ib han sido excelente-bueno en 40 casos y aceptable en 4 casos. Cuatro casos referían sensación de inestabilidad. Los test de Lachman y Pívot-Shift fueron positivos en 3 casos. Con el test de Lysholm se obtuvo resultado excelente-bueno en 36 casos, regular en 6 y malo en 2 casos. Este tipo de plastia presenta una baja morbilidad de la zona dadora del injerto, comparativamente con la plastia HTH patelar antóloga, y sin alteración del aparato extensor.A retrospective study of 44 patients, who underwent an arthroscopically assisted ACL (anterior cruciata ligament) reconstruction with quadrupled semitendinosus/gracilis tendon autografts was performed. The mean age was 25 years. Short term outcomes of knee stability (2 years follow-up) with KT-1000 arthrometer at 30 pounds were excellent or good in 40 cases and acceptable in 4. Pain or joint swelling were not found. Instability complaints were found in 4 cases. Lachman and Pivot-shift were found positive in 3 cases. Lysholm questionnaire scores were excellent or good in 36 cases, fair in 6 cases and per in two cases, the donor site morbidity associated with hamstring harvest seems to be minimal compared with bonepatellar tendon-bone autograft without impairment of the extensor mechanism

ADAtools: Automatic Detection and Classification of Active Deformation Areas from PSI Displacement Maps

This work describes the set of tools developed, tested, and put into production in the context of the H2020 project Multi-scale Observation and Monitoring of Railway Infrastructure Threats (MOMIT). This project, which ended in 2019, aimed to show how the use of various remote sensing techniques could help to improve the monitoring of railway infrastructures, such as tracks or bridges, and thus, consequently, improve the detection of ground instabilities and facilitate their management. Several lines of work were opened by MOMIT, but the authors of this work concentrated their efforts in the design of tools to help the detection and identification of ground movements using synthetic aperture radar interferometry (InSAR) data. The main output of this activity was a set of tools able to detect the areas labelled active deformation areas (ADA), with the highest deformation rates and to connect them to a geological or anthropogenic process. ADAtools is the name given to the aforementioned set of tools. The description of these tools includes the definition of their targets, inputs, and outputs, as well as details on how the correctness of the applications was checked and on the benchmarks showing their performance. The ADAtools include the following applications: ADAfinder, los2hv, ADAclassifier, and THEXfinder. The toolset is targeted at the analysis and interpretation of InSAR results. Ancillary information supports the semi-automatic interpretation and classification process. Two real use-cases illustrating this statement are included at the end of this paper to show the kind of results that may be obtained with the ADAtools.This work has received funding from the Shift2Rail Joint Undertaking under the European Union's Horizon 2020 research and innovation programme, with grant agreement No 777630, project MOMIT, “Multi-scale Observation and Monitoring of railway Infrastructure Threats”. It has been also partially funded by Interreg-Sudoe program of the EU, through the project RISKCOAST (Ref: SOE3/P4/E0868)