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BACKGROUND: The Decade of Healthy Aging (2021-2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging. METHODS: The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information. RESULTS: A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators. CONCLUSIONS: SIESDE is an effective system for providing an overall view of health, aging, and functional dependence.
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Envejecimiento Saludable , Humanos , México , Anciano , Estado de Salud , Sistemas de Información en Salud , Envejecimiento , Anciano de 80 o más AñosRESUMEN
In the pursuit of new lead compounds with fewer side effects than opioids, the novel synthetic phytochemical core, 3,3-dibromoflavanone (3,3-DBF), has emerged as a promising candidate for pain management. Acute assays demonstrated dose-dependent central and peripheral antinociceptive activity of 3,3-DBF through the µ-opioid receptor. This study aimed to explore repeated administration effects of 3,3-DBF in mice and compare them with morphine. Mice were treated with 3,3-DBF (30 mg/kg), morphine (6 mg/kg), or vehicle for 10 days, alongside single-treatment groups. Unlike morphine, 3,3-DBF demonstrated antinociceptive effects in the hot plate test without inducing tolerance. Locomotor activity and motor coordination tests (evaluated through the inverted screen and rotarod tests) revealed no significant differences between the 3,3-DBF-treated and control groups. The gastrointestinal transit assay indicated that 3,3-DBF did not induce constipation, in contrast to morphine. Furthermore, withdrawal signs assessed with the Gellert-Holtzman scale were not comparable to morphine. Additionally, 3,3-DBF exhibited antidepressant-like activity, reducing immobility time in the forced swimming and tail suspension tests, akin to imipramine. In summary, 3,3-DBF demonstrated antinociceptive effects without inducing tolerance or dependence and exhibited antidepressant properties. These findings highlight the potential of 3,3-DBF as a promising therapeutic agent for pain management and its comorbidities, offering advantages over morphine by minimizing side effects.
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Analgésicos , Antidepresivos , Flavonoides , Morfina , Animales , Morfina/farmacología , Morfina/uso terapéutico , Ratones , Antidepresivos/farmacología , Antidepresivos/uso terapéutico , Antidepresivos/química , Masculino , Analgésicos/farmacología , Analgésicos/uso terapéutico , Analgésicos/química , Flavonoides/farmacología , Flavonoides/uso terapéutico , Flavonoides/química , Dolor/tratamiento farmacológico , Manejo del Dolor/métodos , Actividad Motora/efectos de los fármacosRESUMEN
Alcohol is a harmful drug, and reducing its consumption is a significant challenge for users. Furthermore, alcohol dependence is often treatment-resistant, and no completely effective treatment model is available for chemical dependence. Classic psychedelics, such as LSD, psilocybin, and ayahuasca have been used in different clinical and pre-clinical trials, demonstrating promising pharmacotherapeutic effects in the treatment of treatment-resistant psychopathological conditions, such as addiction, especially related to alcohol dependence. In this work, we conducted a narrative review of the emerging research regarding the potential of psychedelics for alcohol use disorder treatment. Psychedelic substances have demonstrated potential for treating drug addiction, especially AUD, mostly by modulating neuroplasticity in the brain. Given that serotonergic psychedelics do not produce physical dependence or withdrawal symptoms with repeated use, they may be considered promising treatment options for managing drug use disorders. However, certain limitations could be found. Although many participants achieve positive results with only one treatment dose in clinical studies, great inter-individual variability exists in the duration of these effects. Therefore, further studies using different doses and experimental protocols should be conducted to enhance evidence about psychedelic substances.
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Alcoholismo , Alucinógenos , Humanos , Alucinógenos/uso terapéutico , Alucinógenos/administración & dosificación , Alcoholismo/tratamiento farmacológico , Animales , Psilocibina/uso terapéutico , Psilocibina/farmacología , Psilocibina/administración & dosificación , Dietilamida del Ácido Lisérgico/uso terapéutico , Dietilamida del Ácido Lisérgico/farmacología , Dietilamida del Ácido Lisérgico/administración & dosificaciónRESUMEN
Resumen El juego patológico constituye un grave problema que afecta a toda la población, principalmente a los más jóvenes, considerando la población universitaria la menos investigada. El presente estudio tuvo como objetivo general caracterizar la dependencia al juego y las apuestas en línea en estudiantes de la Universidad Pontificia Bolivariana seccional Bucaramanga, así como identificar las variables sociodemográficas y presencia de dependencia al juego en la población estudiada. La metodología utilizada en el estudio fue de enfoque cuantitativo de tipo no experimental, con un diseño de corte transversal y descriptivo y con un tipo de muestreo no probabilístico. Se obtuvo la participación de 366 estudiantes mayores de edad de pregrado y posgrado. Los instrumentos utilizados fueron el Cuestionario Breve del Juego Patológico (CBJP), la versión colombiana del Cuestionario del Juego Patológico de South Oaks (SOGS) y un cuestionario de datos sociodemográficos. El análisis de los datos se hizo a través del software SPSS versión 27. Entre los resultados, se destaca que, de los 366 participantes, 110 apuestan en línea, y de estos, aproximadamente, el 30 % tienen posibles problemas de adicción al juego, según el CBJP; con el SOGS se muestra que el 31,8 % son probables jugadores patológicos. Hay mayor prevalencia del juego y apuestas en línea en hombres, y se destaca que la mayoría de las mujeres tienen ausencia de problemas con el juego; por el contrario, en hombres hay una prevalencia en algún problema con el juego.
Abstract Pathological gambling is a serious problem affecting the entire population, especially the youngest, considering the university population the least studied. The general objective of this study was to characterize gambling dependence and online betting on students of the Pontificia Bolivariana University, Bucaramanga sectional, as well as identify the sociodemographic variables and presence of dependence on gambling in the population studied. The methodology used in this study was a quantitative approach of non-experimental type, a cross-sectional and descriptive design, with a non-probabilistic type of sampling. The participation of 366 adult undergraduate and graduate students was obtained. The instruments used were the Pathological Gambling Brief Questionnaire (CBJP), the Colombian version of the South Oaks Gambling Screen (SOGS) and a questionnaire of sociodemographic data. The data analysis was done through the SPSS version 27 software. Among the results, it is highlighted that, of the 366 participants, 110 of these bets online, and approximately 30% have possible pathological gambling according to CBJP, with the SOGS it is shown that 31,8% are probable pathological players; There is a higher prevalence of online gambling and betting in men, it's highlighted that most women have no problems with gambling, on the contrary, in men, there's a prevalence in some problems with gambling.
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We aim to estimate school value-added dynamically in time. Our principal motivation for doing so is to establish school effectiveness persistence while taking into account the temporal dependence that typically exists in school performance from one year to the next. We propose two methods of incorporating temporal dependence in value-added models. In the first we model the random school effects that are commonly present in value-added models with an auto-regressive process. In the second approach, we incorporate dependence in value-added estimators by modeling the performance of one cohort based on the previous cohort's performance. An identification analysis allows us to make explicit the meaning of the corresponding value-added indicators: based on these meanings, we show that each model is useful for monitoring specific aspects of school persistence. Furthermore, we carefully detail how value-added can be estimated over time. We show through simulations that ignoring temporal dependence when it exists results in diminished efficiency in value-added estimation while incorporating it results in improved estimation (even when temporal dependence is weak). Finally, we illustrate the methodology by considering two cohorts from Chile's national standardized test in mathematics.
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Modelos Estadísticos , Humanos , Psicometría/métodos , Estudios de Cohortes , Instituciones Académicas , Chile , Factores de Tiempo , Niño , Simulación por ComputadorRESUMEN
Despite prenol emerging as a next-generation biofuel, some questions about its mechanism still need to be adequately proposed to rationalize its consumption and evaluate its efficiency in spark-ignition (SI) engines. Here, we present new insights into the reaction mechanism of prenol (3-methyl-2-buten-1-ol) with OH radicals as a function of temperature and pressure. We have determined that the different temperature and pressure conditions control the preferred products. At combustion temperatures and low pressures, OH-addition adducts are suppressed, increasing the formation of α and δ allylic radicals responsible for the auto-ignition.
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Lianas are major contributors to tropical forest dynamics, yet we know little about their mortality. Using overlapping censuses of the lianas and trees across a 50 ha stand of moist tropical forest, we contrasted community-wide patterns of liana mortality with relatively well-studied patterns of tree mortality to quantify patterns of liana death and identify contributing factors. Liana mortality rates were 172% higher than tree mortality rates, but species-level mortality rates of lianas were similar to trees with 'fast' life-history strategies and both growth forms exhibited similar spatial and size-dependent patterns. The mortality rates of liana saplings (<2.1 cm in diameter), which represent about 50% of liana individuals, decreased with increasing disturbance severity and remained consistently low during post-disturbance stand thinning. In contrast, larger liana individuals and trees of all sizes had elevated mortality rates in response to disturbance and their mortality rates decreased over time since disturbance. Within undisturbed forest patches, liana mortality rates increased with increasing soil fertility in a manner similar to trees. The distinct responses of liana saplings to disturbance appeared to distinguish liana mortality from that of trees, whereas similarities in their patterns of death suggest that there are common drivers of woody plant mortality.
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Bosques , Árboles , Clima TropicalRESUMEN
Negative density dependence (NDD) in biotic interactions of interference such as plant-plant competition, granivory and herbivory are well-documented mechanisms that promote species' coexistence in diverse plant communities worldwide. Here, we investigated the generality of a novel type of NDD mechanism that operates through the mutualistic interactions of frugivory and seed dispersal among fruit-eating birds and plants. By sampling community-wide frugivory interactions at high spatial and temporal resolution in Pennsylvania, Puerto Rico, Peru, Brazil and Argentina, we evaluated whether interaction frequencies between birds and fruit resources occurred more often (selection), as expected, or below expectations (under-utilization) set by the relative fruit abundance of the fruit resources of each plant species. Our models considered the influence of temporal scales of fruit availability and bird phylogeny and diets, revealing that NDD characterizes frugivory across communities. Irrespective of taxa or dietary guild, birds tended to select fruits of plant species that were proportionally rare in their communities, or that became rare following phenological fluctuations, while they mostly under-utilized abundant fruit resources. Our results demonstrate that negative density-dependence in frugivore-plant interactions provides a strong equalizing mechanism for the dispersal processes of fleshy-fruited plant species in temperate and tropical communities, likely contributing to building and sustaining plant diversity. This article is part of the theme issue 'Diversitydependence of dispersal: interspecific interactions determine spatial dynamics'.
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Aves , Frutas , Simbiosis , Animales , Aves/fisiología , Frutas/fisiología , Dispersión de Semillas , Conducta Alimentaria , Densidad de Población , Herbivoria , Argentina , Pennsylvania , Brasil , Puerto RicoRESUMEN
Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.
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Actividades Cotidianas , Demencia , Humanos , Demencia/diagnóstico , Demencia/psicología , Actividades Cotidianas/psicología , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Pruebas Neuropsicológicas , Envejecimiento/psicología , Envejecimiento/fisiologíaRESUMEN
The effects of biodiversity on ecological processes have been experimentally evaluated mainly at the local scale under homogeneous conditions. To scale up experimentally based biodiversity-functioning relationships, there is an urgent need to understand how such relationships are affected by the environmental heterogeneity that characterizes larger spatial scales. Here, we tested the effects of an 800-m elevation gradient (a large-scale environmental factor) and forest habitat (a fine-scale factor) on litter diversity-decomposition relationships. To better understand local and landscape scale mechanisms, we partitioned net biodiversity effects into complementarity, selection, and insurance effects as applicable at each scale. We assembled different litter mixtures in aquatic microcosms that simulated natural tree holes, replicating mixtures across blocks nested within forest habitats (edge, interior) and elevations (low, mid, high). We found that net biodiversity and complementarity effects increased over the elevation gradient, with their strength modified by forest habitat and the identity of litter in mixtures. Complementarity effects at local and landscape scales were greatest for combinations of nutrient-rich and nutrient-poor litters, consistent with nutrient transfer mechanisms. By contrast, selection effects were consistently weak and negative at both scales. Selection effects at the landscape level were due mainly to nonrandom overyielding rather than spatial insurance effects. Our findings demonstrate that the mechanisms by which litter diversity affects decomposition are sensitive to environmental heterogeneity at multiple scales. This has implications for the scaling of biodiversity-ecosystem function relationships and suggests that future shifts in environmental conditions due to climate change or land use may impact the functioning of aquatic ecosystems.
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Biodiversidad , Bosques , Hojas de la Planta , Modelos Biológicos , Árboles/fisiologíaRESUMEN
The aim of the present study was to evaluate and compare exercise addiction (EA) between runners, cyclists, swimmers, and triathletes. Took part in this study 39 runners, 32 cyclists, 30 swimmers and 38 triathletes. Exercise Dependence Scale (EDS), and the Exercise Addiction Inventory (EAI) was used to evaluate the EA and classified the participants into: at-risk for EA, nondependent-symptomatic, and nondependent-asymptomatic. Most participants were classified as nondependent symptomatic for EA. The EDS total score was significantly lower in the swimmers compared to the cyclists and triathletes and the EAI total score was significantly higher for cyclists compared to runners. Therefore, in both instruments, the majority of participants was nondependent symptomatic for EA (AU).
O objetivo do presente estudo foi avaliar e comparar a dependência ao exercício (DE) entre corredores, ciclistas, nadadores e triatletas. Participaram do estudo 39 corredores, 32 ciclistas, 30 nadadores e 38 triatletas. As escalas Exercise Dependence Scale (EDS) e Exercise Addiction Inventory (EAI) foram usadas para a avaliação da DE e classificaram os participantes em três categorias: em risco de DE, não dependente sintomático e não dependente assintomático. A maioria dos participantes foram classificadas como não dependentes sintomáticos para DE. O escore da EDS foi significativamente menor nos nadadores comparado aos ciclistas e triatletas e o escore total da EAI foi significantemente maior nos ciclistas comparado aos corredores. Portanto, em ambos os instrumentos, a maioria dos participantes foi não dependente sintomático para DE (AU).
El objetivo del presente estudio fue evaluar y comparar la adicción al ejercicio (AE) entre corredores, ciclistas, nadadores y triatletas. Participaron de este estudio 39 corredores, 32 ciclistas, 30 nadadores y 38 triatletas. La Escala de Dependencia al Ejercicio (EDS) y el Inventario de Adicción al Ejercicio (EAI) fueron utilizados para evaluar la AE y clasificaron a los participantes en tres categorías: en riesgo de AE, no dependiente-sintomático y no dependiente-asintomático. La mayoría de los participantes se clasificaron como no dependiente-sintomático para AE. La puntuación EDS fue significativamente menor en nadadores en comparación con ciclistas y triatletas y la puntuación EAI total fue significativamente mayor en ciclistas en comparación con corredores. Por lo tanto, en ambos instrumentos, la mayoría de los participantes eran sintomáticos no dependientes para AE
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Humanos , Resistencia Física , Deportes , Atletas , Entrenamiento AeróbicoRESUMEN
The aim of the present study was to evaluate and compare exercise addiction (EA) between runners, cyclists, swimmers, and triathletes. Took part in this study 39 runners, 32 cyclists, 30 swimmers and 38 triathletes. Exercise Dependence Scale (EDS), and the Exercise Addiction Inventory (EAI) was used to evaluate the EA and classified the participants into: at-risk for EA, nondependent-symptomatic, and nondependent-asymptomatic. Most participants were classified as nondependent symptomatic for EA. The EDS total score was significantly lower in the swimmers compared to the cyclists and triathletes and the EAI total score was significantly higher for cyclists compared to runners. Therefore, in both instruments, the majority of participants was nondependent symptomatic for EA.
O objetivo do presente estudo foi avaliar e comparar a dependência ao exercício (DE) entre corredores, ciclistas, nadado-res e triatletas. Participaram do estudo 39 corredores, 32 ciclistas, 30 nadadores e 38 triatletas. As escalas Exercise Dependence Scale (EDS) e Exercise Addiction Inventory (EAI) foram usadas para a ava-liação da DE e classificaram os participantes em três categorias: em risco de DE, não dependente sintomático e não dependente assintomático. A maioria dos participantes foram classificadas como não dependentes sintomáticos para DE. O escore da EDS foi significativamente menor nos nadadores comparado aos ciclistas e triatletas e o escore total da EAI foi significantemente maior nos ciclistas comparado aos corredores. Portanto, em ambos os ins-trumentos, a maioria dos participantes foi não dependente sinto-mático para DE.
El objetivo del presente estudio fue evaluar y comparar la adicción al ejercicio (AE) entre corredores, ciclistas, nadadores y triatletas. Participaron de este estudio 39 corredores, 32 ciclistas, 30 nadadores y 38 triatletas. La Escala de Dependencia al Ejercicio (EDS) y el Inventario de Adicción al Ejercicio (EAI) fueron utilizados para evaluar la AE y clasificaron a los participantes en tres categorías: en riesgo de AE, no dependiente-sintomático y no dependiente-asintomático. La mayoría de los participantes se clasificaron como no dependiente-sintomático para AE. La puntuación EDS fue significativamente menor en nadadores en comparación con ciclistas y triatletas y la puntuación EAI total fue significativamente mayor en ciclistas en comparación con corredores. Por lo tanto, en ambos instrumentos, la mayoría de los participantes eran sintomáticos no dependientes para AE.
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The aim of this study was to analyse the relationship between dating violence and emotional dependence in young university students in Ecuador by identifying differences based on sex. Using purposive non-probabilistic sampling, 3203 students were selected, of which 35.7% were men and 64.3% were women aged 16 to 48 (M = 21.50; SD = 2.82). Two psychological scales were applied: Questionnaire on Violence in Couples (CUVINO) and Questionnaire on Emotional Dependence (EDQ). According to the results obtained, based on sex, it was found that dating violence is a severe problem that both men and women experience. With regard to emotional dependence, women scored higher than men. In addition, emotional dependence was linked to dating violence. The implications of the results obtained for further research and for prevention and intervention programmes are presented, and the strengths and limitations of this study are detailed.
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Introducción: El consumo de drogas es un problema de salud que se presenta con mayor frecuencia en la población joven, pues su prevalencia aumenta cada día. En la actualidad existe preocupación sobre la percepción de riesgo del consumo de drogas en estudiantes universitarios. Objetivo: Describir la percepción de riesgo sobre el consumo de drogas en estudiantes universitarios de la provincia Manabí en Ecuador. Métodos: Investigación descriptiva y transversal; universo de 787 estudiantes universitarios de la provincia Manabí en Ecuador. La muestra quedó conformada por 259 estudiantes. Se utilizó la encuesta como técnica de recolección de datos. Como instrumento de investigación se utilizaron las encuestas escolares sobre el uso indebido de drogas de la oficina de las Naciones Unidas contra la droga y el delito. Se utilizó la estadística descriptiva para el procesamiento de los datos. Resultados: Se obtuvo una media de edad de 22,37 años, predominio del sexo femenino (65,25 %) y de estudiantes que consumen algún tipo de droga (79,92 %). El 91,30 % refirió consumo de drogas lícitas (tabaco 43,63 % y alcohol 61,39 %); el 31,26 % consumían drogas medicamentosas y el 23,29 % drogas ilícitas; de ellos, el 85,42 % refirió consumo de marihuana. El 32,04 % tenía una percepción baja sobre el riesgo de consumo de drogas. Conclusiones: En el grupo de estudiantes universitarios de la provincia Manabí que son investigados, existe un aumento del consumo de drogas lícitas, medicamentosas e ilícitas debido a una percepción deficiente del riesgo de consumo de estas sustancias.
Introduction: Drug use is a health problem that occurs more frequently in the young population; its prevalence increases every day. Currently, there is concern about the perception of risk of drug use in university students. Objective: Describe the risk perception of drug consumption in university students from the Manabí province in Ecuador. Methods: Descriptive and cross-sectional research; universe of 787 university students from the Manabí province in Ecuador. The sample was made up of 259 students. The survey was used as a data collection technique. The School Surveys on Drug Abuse from the United Nations Office on Drugs and Crime were used as a research instrument. Descriptive statistics were used to process the data. Results: An average age of 22.37 years was obtained, predominance of the female sex (65.25%) and students who consume some type of drug (79.92%). 91.30% reported consumption of legal drugs (tobacco 43.63% and alcohol 61.39%); 31.26% used medicinal drugs and 23.29% used illicit drugs; Of them, 85.42% reported marijuana use. 32.04% had a low perception of the risk of drug use. Conclusions: In the group of university students from the Manabí province who are investigated, there is an increase in the consumption of licit, medicinal and illicit drugs due to a poor perception of the risk of consumption of these substances.
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In this paper we discuss the details, limitations, and difficulties of the implementation in hardware of a memristor-based random number generator that exhibits monofractal/multifractal behavior. To do so, the components and selection criteria of a reference memristor and one proposed by the authors, the chaotic circuit leveraging them, and the processing that is performed on the chaotic signals to achieve the random discrete sequences are described. After applying the estimation tools, findings indicate that more than 60% of the proposed combinations allow generating random discrete sequences, with long-range dependence, and that both monofractal and multifractal behaviors can also be obtained. Consequently, a hardware system was achieved that can be used as a source of entropy in future synthetic biological signal generators.
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PURPOSE: To evaluate compulsive exercise, researchers often rely on the widely used Compulsive Exercise Test (CET). However, the measure has shown unstable factor structure in several validation studies and is not available in Portuguese for use in Brazil. We aimed to describe the translation and cultural adaptation of the CET to Brazilian Portuguese, to test several factor structures among Brazilian and US samples of men and women, to test measurement invariance across countries, and to evaluate its internal consistency. Furthermore, we sought to evaluate convergent validity, correlating the CET with a measure of eating disorder symptoms, and to compare compulsive exercise symptoms between countries. METHODS: Four models of the latent structure of the CET were tested using confirmatory factor analyses (CFAs), three-factor structure with 15 items, three-factor structure with 18 items, four-factor structure with 21 items, and the original five-factor structure with 24 items, in a sample of 1,531 young adults (601 Brazilians and 930 Americans), aged 18-35 years. RESULTS: A series of CFAs demonstrated that the three-factor structure with 15 items showed a better fit to the data. This model demonstrated good convergent validity and internal consistency. Results from the CET multigroup CFA showed evidence for the invariance at the configural, metric, and scalar levels across Brazilians and Americans. Furthermore, significant differences were found between Brazilians and Americans, with Brazilians demonstrating higher scores on the Avoidance and rule-driven behavior and Mood improvement subscales, whereas US participants scored higher on the Weight control exercise subscale. CONCLUSIONS: Results support the three-factor structure with 15 items to be used as a measure of compulsive exercise among Brazilians and Americans, allowing cross-cultural comparisons between these countries. LEVEL OF EVIDENCE: Level V, Cross-sectional, Psychometric study.
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Ejercicio Compulsivo , Encuestas y Cuestionarios , Femenino , Humanos , Masculino , Adulto Joven , Brasil , Estudios Transversales , Psicometría/métodos , Reproducibilidad de los Resultados , Estados UnidosRESUMEN
INTRODUÇÃO: O tabagismo é considerado uma doença crônica de dependência da nicotina e um fator de risco para doenças graves como câncer e doenças cardiovasculares, além de ser uma das principais causas de mortes evitáveis no mundo. Os programas de controle do uso do tabaco atingiram um bom resultado nas últimas décadas, com a redução do número de fumantes. Contudo, verifica-se que o tratamento medicamentoso e comportamental não apresenta 100% de eficácia, com recaídas e efeitos colaterais para o fumante. Novos desafios foram impostos após a pandemia da COVID-19, principalmente no setor da saúde, no qual a preocupação com os impactos na saúde dos trabalhadores e das trabalhadoras ficou em evidência. Nesse cenário, foi verificada a importância de cuidar dos que mais se expuseram aos efeitos nocivos desse período, voltando o olhar não somente para transtornos a nível psíquico dessa parcela populacional, mas também para a promoção da qualidade de vida do trabalhador, principalmente do trabalhador que apresenta um comportamento de risco em saúde, como por exemplo, o trabalhador tabagista. A aromaterapia, uma Prática Integrativa e Complementar em Saúde apoiada em evidências de efetividade clínica nas mais diversas condições clínicas, foi proposta como intervenção neste grupo. OBJETIVO: Avaliar a efetividade da aromaterapia na dependência de nicotina em trabalhadores tabagistas. MÉTODO: Estudo piloto, clínico, randomizado, duplo-cego que utilizou dois óleos essenciais, piper nigrum e angelica archangelica, por meio de inalação, em dois grupos de trabalhadores da saúde, para avaliar o efeito desses óleos nos níveis de dependência do tabagismo. Os desfechos avaliados foram o nível de dependência de nicotina (desfecho primário), mensurado por meio do Teste de Fagerstrom, e a medida da carga tabágica (desfecho secundário) do participante. A pesquisa foi desenvolvida em um período de 30 dias nas dependências de um hospital universitário da cidade de Belo Horizonte/MG com uma população de 29 trabalhadores tabagistas. A análise dos dados foi realizada por meio do programa SPSS versão 21.0 e as mudanças nos níveis de dependência da nicotina e de carga tabágica no estudo foram avaliadas utilizando o teste de Wilcoxon emparelhado. As associações entre as variáveis categorizadas foram feitas por meio do teste qui-quadrado de Pearson. A efetividade dos óleos essenciais entre os grupos foi realizada pelo Teste de Mann-Whitney. Para todos os testes, foi fixado o nível de significância de 5%. RESULTADOS: Os grupos aleatorizados foram semelhantes entre si na maioria das variáveis analisadas (p>0,05). Houve diminuição tanto da carga tabágica quanto no teste de dependência à nicotina após a intervenção com os óleos essenciais em ambos os grupos (p<0,05), com o grupo Angélica iniciando a pesquisa com um grau moderado de dependência no Teste de Fagerstrom e carga tabágica moderada, e ao final demonstrando uma baixa dependência e carga tabágica baixa. Da mesma maneira, o grupo Pimenta-preta exibiu uma baixa dependência de nicotina e carga tabágica baixa no teste inicial e após a intervenção, uma baixíssima dependência. Dois participantes do sexo masculino, cada um de um grupo avaliado, alcançou a abstinência. Não houve diferença significativa (p>0,05) no tamanho do efeito em relação ao tipo de óleo essencial utilizado. CONCLUSÃO: Os óleos essenciais utilizados na pesquisa foram efetivos na redução da dependência da nicotina e na diminuição da carga tabágica dos sujeitos avaliados. Não houve diferença significativa entre o efeito dos OE do grupo controle em relação ao grupo experimental.
INTRODUCTION: Smoking is considered a chronic nicotine addiction disease and a risk factor for serious illnesses such as cancer and cardiovascular disease, as well as being one of the main causes of preventable deaths worldwide. Tobacco control programs have achieved good results in recent decades, with a reduction in the number of smokers. However, drug and behavioral treatment is not 100% effective, with relapses and side effects for smokers. New challenges have been imposed following the COVID-19 pandemic, especially in the health sector, where concerns about the impact on workers' health have been highlighted. In this scenario, the importance of caring for those who have been most exposed to the harmful effects of this period has been verified, looking not only at the psychological disorders of this population, but also at promoting the quality of life of the worker, especially the worker who presents a health risk behavior, such as the smoking worker. Aromatherapy, an Integrative and Complementary Health Practice supported by evidence of clinical effectiveness in a wide range of clinical conditions, was proposed as an intervention for this group. OBJECTIVE: To evaluate the effectiveness of aromatherapy on nicotine dependence in workers who smoke. METHOD: A pilot, clinical, randomized, double-blind study using two essential oils, piper nigrum and angelica archangelica, by inhalation, in two groups of health workers, to evaluate the effect of these oils on levels of smoking dependence. The outcomes assessed were the level of nicotine dependence (primary outcome), measured using the Fagerstrom Test, and the measure of the participant's smoking load (secondary outcome). The study was carried out over a period of 30 days on the premises of a university hospital in the city of Belo Horizonte/MG with a population of 29 workers who were smokers. Data analysis was carried out using the SPSS program version 21.0 and changes in levels of nicotine dependence and smoking load in the study were assessed using the paired Wilcoxon test. Associations between the categorized variables were made using Pearson's chi-square test. The effectiveness of the essential oils between the groups was assessed using the Mann-Whitney test. A significance level of 5% was set for all tests. RESULTS: The randomized groups were similar in most of the variables analyzed (p>0.05). There was a decrease in both smoking load and nicotine dependence after the intervention with essential oils in both groups (p<0.05), with the Angelica group starting the study with a moderate degree of dependence in the Fagerstrom test and moderate smoking load, and at the end showing low dependence and low smoking load. Similarly, the Black Pepper group exhibited a low nicotine dependence and low smoking load in the initial test and after the intervention, a very low dependence. Two male participants, each from an evaluated group, achieved abstinence. There was no significant difference (p>0.05) in effect size in relation to the type of essential oil used. CONCLUSION: The essential oils used in the study were effective in reducing nicotine dependence and the smoking burden of the subjects evaluated. There was no significant difference between the effect of EOs in the control group and the experimental group.
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Terapias Complementarias , Resultado del TratamientoRESUMEN
Chronic opioid intake leads to several brain changes involved in the development of dependence, whereby an early hedonistic effect (liking) extends to the need to self-administer the drug (wanting), the latter being mostly a prefrontal-striatal function. The development of animal models for voluntary oral opioid intake represents an important tool for identifying the cellular and molecular alterations induced by chronic opioid use. Studies mainly in humans have shown that polydrug use and drug dependence are shared across various substances. We hypothesize that an animal bred for its alcohol preference would develop opioid dependence and further that this would be associated with the overt cortical abnormalities clinically described for opioid addicts. We show that Wistar-derived outbred UChB rats selected for their high alcohol preference additionally develop: (i) a preference for oral ingestion of morphine over water, resulting in morphine intake of 15 mg/kg/day; (ii) marked opioid dependence, as evidenced by the generation of strong withdrawal signs upon naloxone administration; (iii) prefrontal cortex alterations known to be associated with the loss of control over drug intake, namely, demyelination, axonal degeneration, and a reduction in glutamate transporter GLT-1 levels; and (iv) glial striatal neuroinflammation and brain oxidative stress, as previously reported for chronic alcohol and chronic nicotine use. These findings underline the relevance of polydrug animal models and their potential in the study of the wide spectrum of brain alterations induced by chronic morphine intake. This study should be valuable for future evaluations of therapeutic approaches for this devastating condition.
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Dependencia de Morfina , Trastornos Relacionados con Sustancias , Humanos , Ratas , Animales , Morfina/efectos adversos , Analgésicos Opioides/farmacología , Ratas Wistar , Naloxona/farmacología , Encéfalo , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Etanol/farmacología , Antagonistas de Narcóticos/farmacologíaRESUMEN
PURPOSE: To investigate which of the residual sensorimotor impairments, assessed by the Fugl-Meyer scale, would best explain functional independence during hospitalization after a stroke. METHODS: This cross-sectional study retrieved data from medical records between January 2014 to December 2021. Explanatory independent variables were the following domains of the Fugl-Meyer scale: joint pain, joint range of motion, balance, sensory function, and motor function of the upper and lower limbs. Functional independence was measured by the Functional Independence Measure (FIM). Step-wise multiple linear regression analysis was used to identify which measures would explain functional independence (α=5%). RESULTS: Data from 1,344 individuals, who had a mean age of 64 years, were retrieved. All included explanatory variables were significantly correlated with the FIM scores (0.24 ≤ r ≤ 0.87). Balance alone explained 76 % (F=4.24; p<0.001) of the variance in the FIM scores. When sensory function and upper-limb motor function scores were included in the model, the explained variance increased to 82 % (F = 1.935; p < 0.001). CONCLUSIONS: Balance, which is important for carrying-out self-care activities, is the domain of the Fugl-Meyer scale that best explained functional independence during hospitalization after a stroke. Although sensory function and motor function of the upper limb added little to the explained variance, they should not be underlooked. Future research is needed to determine whether progressive balance training interventions would enhance functional independence after a stroke.
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Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Persona de Mediana Edad , Estado Funcional , Actividades Cotidianas , Estudios Transversales , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia , Hospitalización , Extremidad Superior , Recuperación de la FunciónRESUMEN
Cigarette smoking remains an important health concern and is still a leading cause of preventable mortality. Nicotine is the substance responsible for sustained tobacco use and dependence. Identification of biomarkers underlying nicotine dependence behavior is important to identify people at risk for this dependence. In the present study, we identified biochemical and genetic biomarkers of nicotine dependence detected by the Fagerström Test for Nicotine Dependence (FTDN) in Mexican smokers. The nicotine metabolites nicotine-N'-oxide, trans-3'-hydroxycotinine-glucuronide (3HC-O-Gluc), and nicotine-N-Gluc (Gluc) were useful to differentiate nicotine-dependent from non-dependent subjects (p < .0001) with an area under the curve (AUC) of 0.7818. Genetic variants in CYP2A6, FMO3, and UGT2B7 (rs2431413, rs28363545, and rs7439326, respectively) were associated with nicotine dependence (p = .03, p = .01, p = .01, respectively). Variations in the enzymatic activity of CYP2A6 were associated with altered nicotine-N'-oxide and 3HC-O-Gluc levels. Decreased urinary levels of 3HC-O-Gluc and increased nicotine-N'-oxide were associated with a decrease in the functional activity of CYP2A6. A strong positive correlation was observed between the ratio of urinary 3HC/cotinine, a measure of CYP2A6 activity, and the levels of 3HC-O-Gluc (p < .0001, r = .6835), while a strong negative correlation was observed with nicotine-N'-oxide (p < .0001, r = .6522) in nicotine-dependent subjects. No correlations were observed in non-nicotine-dependent subjects. These data suggest that particular urinary nicotine metabolites and genetic variants involved in nicotine metabolism are useful to identify subjects with nicotine dependence in the Mexican population.