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Abstract Introduction: Aquatic birds (AB) are usually associated with wetlands, which provide refuge, food, and/or nesting sites for resident and migratory species. Despite their ecological importance, there is little knowledge on AB in some tropical environments, such as those found on the Colima coast. Objective: To investigate the spatial and temporal composition of the AB community in Juluapan Lagoon, Colima, Central Mexican Pacific. Methods: Monthly counts were conducted between June 2017 and May 2018 during low-tide conditions to record habitat use by AB. Species richness and bird counts were obtained to compare sampling areas; mean richness and number of individuals were compared between seasons. Results: We detected 53 species and 5 750 individuals. The highest species richness and relative abundance values were obtained in winter at the lagoon area farthest from the connection with the marine system, where anthropogenic activity is lower. Diversity was greater in zones 2 and 3 in spring, summer, and fall. Muddy flats were the most used environment, and the most frequent activity was resting. Nesting activity was only recorded in the middle of the lagoon at the mangrove during spring. "Shorebirds" and "waders" were the most dominant groups in the bird community of the Juluapan lagoon. Conclusions: This coastal wetland is a site of great biological importance for aquatic birds; thus, conservation measures should be implemented, and there should be a continuous study of the effects of anthropogenic pressure.

Resumen Introducción: Las aves acuáticas (AA) son usualmente relacionadas a los humedales debido a que éstos funcionan como sitios de refugio, alimentación y anidación de diferentes especies residentes y migratorias. Sin embargo, el conocimiento sobre las aves acuáticas en algunos humedales es nulo. Objetivo: Investigar la composición espacio-temporal de la comunidad de AA en la laguna Juluapan, Colima, en el Pacífico Central Mexicano. Métodos: Entre junio de 2017 y mayo de 2018 se llevaron a cabo conteos mensuales en condiciones de marea baja para registrar el uso de hábitat de las AA. Se obtuvieron valores de riqueza de especies y número de individuos para realizar comparaciones entre zonas de muestreo, así como el promedio del número de especies y número de individuos para comparaciones entre temporadas. Resultados: Se registraron un total de 53 especies y 5 750 individuos. Los valores de riqueza de especies y densidad de individuos fueron más altos durante invierno, en la zona más alejada al ambiente marino, donde la actividad antropogénica es menor. La diversidad tuvo valores más altos en la zona 2 y 3, durante primavera, verano y otoño. El ambiente más explotado por las aves fueron las planicies lodosas; y el descanso fue la actividad más frecuente. Asimismo, la actividad de anidación sólo se registró en el manglar de la zona media durante primavera. Las "aves playeras" y "aves zancudas" fueron los grupos más predominantes en la comunidad de aves de la laguna Juluapan. Conclusiones: Este humedal costero es un sitio de gran importancia biológica para aves acuáticas, por lo que resulta necesario la implementación de medidas de conservación, así como el estudio de los efectos por la presión antropogénica.

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The burgeoning illegal trade in succulents in southern Africa presents a critical conservation and social development challenge. Drawing parallels with the trajectory of the response to rhinoceros poaching, we considered the consequences of conservation law enforcement measures, particularly the militarization of antipoaching efforts. The response to rhinoceros poaching not only resulted in so-called green militarization, but also led to extrajudicial killings, human rights abuses, and the disproportionate targeting of low-level poachers. The nature of wildlife trade prohibition is complex and often contested, and many actors operating in illegal wildlife trades dispute the label of illegal for socioeconomic, cultural, historical, or political reasons. This contestation is crucial when considering Indigenous cultural and medicinal values of succulents, with Indigenous Peoples and local communities questioning the criminalization of traditional plant harvesting practices. As the illegal trade in succulents continues to grow, it is imperative for conservationists to consider a nuanced approach. We call for a socioecological harm reduction approach that emphasizes community engagement, sustainable use, and codesigned interventions. Such an approach could help balance the scales of ecological conservation and human dignity in the face of growing wildlife trade challenges.

La necesidad de una estrategia socioecológica de reducción de daño para disminuir el mercado ilegal de fauna Resumen El emergente mercado ilegal de suculentas en el sur de África representa un reto importante para la conservación y el desarrollo social. Partimos de las similitudes con la trayectoria de la respuesta a la caza furtiva de rinocerontes para considerar las consecuencias de la aplicación de las leyes de conservación, en particular la militarización de los esfuerzos contra la caza furtiva. La respuesta a la caza furtiva no sólo derivó en la llamada militarización verde, sino también llevó a ejecuciones extrajudiciales, abuso de los derechos humanos y a la selección desproporcionada de cazadores de bajo nivel. La naturaleza de la prohibición del mercado de fauna es compleja y con frecuencia se impugna, y muchos actores que operan en los mercados ilegales disputan la etiqueta ilegal por razones socioeconómicas, culturales, históricas o políticas. Esta impugnación es crucial cuando consideramos los valores culturales y medicinales que los indígenas dan a las suculentas, sobre todo cuando los pueblos indígenas y las comunidades locales cuestionan la criminalización de las prácticas tradicionales de recolección de plantas. Conforme el mercado ilegal de suculentas sigue creciendo, es imperativo que los conservacionistas consideren una estrategia con matices. Pedimos una estrategia socioecológica de reducción de daños que resalte la participación comunitaria, el uso sustentable y las intervenciones con co­diseño. Dicha estrategia podría ayudar a equlibrar la balanza de la conservación ecológica y la dignidad humana de cara al incremento de retos en el mercado de fauna.

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Global wildlife trade involves a diverse array of species. Although sustainable trade underpins livelihoods for communities worldwide, unsustainable trade, whether legal or illegal, threatens thousands of species and can lead to extinctions. From plants and fungi to fish, amphibians, mammals, invertebrates, and reptiles, a diverse array of species across taxa are affected by trade. Attention to wildlife trade has increased in recent years, but its focus has largely remained on a narrow range of high-profile species, with taxa deemed less charismatic frequently overlooked, despite some having significant trade volumes and levels of threat to wild populations. These biases can hamper effective policy interventions, reduce awareness of wider threats from trade, and prevent conservation efforts from focusing on the most pressing issues. It is important to broaden the scope of research and policy discussions and create a more inclusive approach to trade management. The diversity of approaches to wildlife trade can be improved by expanding monitoring of trade to a wider variety of taxa; collecting fundamental ecological data to underpin assessments of trade sustainability; improving and codesigning conservation interventions with key stakeholders and trade actors; and developing appropriate strategies for managing the supply, trade, and demand in diverse wildlife products to ensure species and livelihoods are protected.

Creación de un enfoque más inclusivo para la gestión del mercado de vida silvestre Resumen El mercado global de vida silvestre involucra a una diversa gama de especies. Mientras que el mercado sustentable apoya al sustento de las comunidades, el mercado insostenible, sea legal o ilegal, amenaza a miles de especies y puede causar extinciones. Desde plantas y hongos hasta peces, anfibios, mamíferos, invertebrados y reptiles, una diversa gama de especies de diferentes taxones se ve afectada por el mercado. Aunque la atención hacia el mercado de vida silvestre ha aumentado en años recientes, su enfoque ha sido principalmente en especies de perfil elevado, por lo que se suele ignorar a taxones considerados menos carismáticos, a pesar de que algunos cuenten con importantes volúmenes de comercio o niveles de amenaza para las poblaciones silvestres. Estos sesgos pueden complicar las intervenciones políticas eficientes, reducir la conciencia sobre las amenazas mayores del comercio y prevenir que los esfuerzos de conservación se enfoquen en los temas más urgentes. Es importante que se amplíe el objetivo de la investigación y las discusiones políticas y se cree un enfoque más inclusivo para la gestión del mercado. Se puede mejorar la diversidad de enfoques sobre el mercado de vida silvestre con la expansión del monitoreo del mercado hacia una mayor variedad de taxones; la colecta de datos ecológicos fundamentales para sostener los análisis sobre la sustentabilidad del mercado; la mejora y el diseño de las intervenciones de conservación conjuntamente con los actores clave del mercado; y el desarrollo de estrategias adecuadas para la gestión de la oferta, comercio y demanda de diferentes productos de vida silvestre para asegurar que se protejan las especies y el sustento de las comunidades.

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Parents' language use is an important context for early socialization. We examined the relationship between parents' self-reported mindfulness and observed language use in two forms of attachment-relevant communication. Sixty-three parents of 6-18-month-old infants from Australia (n = 32) and New Zealand (n = 31) completed the five facets of mindfulness-short form (FFMQ-SF) questionnaire, the adult attachment interview (AAI), and a 10-min play session with their infant. We examined parents' frequency of word usage within the categories of the linguistic inquiry word count (LIWC) text analysis program to explore the relationship between mindfulness and language use. Mindfulness was associated with cognitive, affective, perceptual, and time orientation language use in the AAI. However, fewer associations were identified between mindfulness and language use in the parent-infant play session. Results are discussed in terms of their relevance to mindfulness and attachment.

El uso del lenguaje por parte de los padres es un contexto importante para la temprana socialización. Examinamos la relación entre la auto reportada atención consciente de los padres y el observado uso del lenguaje en dos formas de comunicación relevantes a la unión afectiva. Sesenta y tres progenitores de infantes entre 6 y 18 meses de edad de Australia (n = 32) y Nueva Zelanda (n = 31) completaron el cuestionario de Cinco Facetas de la Atención Consciente en su formato corto (FFMQ­SF), la Entrevista de la Afectividad Adulta (AAI), así como una sesión de juego de diez minutos con sus infantes. Examinamos la frecuencia del uso de palabras por parte de los padres dentro de las categorías del programa de análisis de texto Investigación Lingüística del Conteo de Palabras (LIWC) para explorar la relación entre la atención consciente y el uso del lenguaje. Se asoció la atención consciente con el uso del lenguaje cognitivo, afectivo, perceptivo y con orientación del tiempo de la AAI. Sin embargo, menos asociaciones se identificaron entre la atención consciente y el uso del lenguaje en la sesión de juego entre progenitor e infante. Los resultados se discuten en términos de su relevancia para la atención consciente y la afectividad.

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The need for strategies to tackle substance abuse reveals the urgent need to reformulate care models. This article reports on the pedagogical experience of undergraduate nursing students in developing knowledge aligned with the needs of alcohol and other drug users. Method: An experience report aimed at reflecting on pedagogical strategies in the training of nurses. The population consisted of 37 students from the second and third periods of the undergraduate nursing course. The activities were developed in three main stages: 1) Participation in Debate Cycles; 2) Classes on Pedagogical Strategies; and 3) Preparation and Presentation of Interventions. Results: The development of pedagogical strategies by the students, revealed a significant effort to face the challenges associated with the abusive use of alcohol and other drugs. The predominant choice of digital technologies, such as apps and websites, highlights a growing trend to incorporate technological resources into health education and intervention, reflecting the evolution of pedagogical practices and adaptation to contemporary needs. Conclusion:The methodological approach adopted, which included participation in debate cycles, the application of active methodologies and the development of digital technologies, highlighted the students' ability to create relevant educational solutions adapted to contemporary needs.

La necesidad de estrategias para abordar el abuso de sustancias revela la urgencia de reformular los modelos de atención. El artículo relata la experiencia pedagógica de estudiantes universitarios de enfermería en el desarrollo de conocimientos alineados con las necesidades de los consumidores de alcohol y otras drogas. Método: Reporte de experiencia con el objetivo de reflexionar sobre las estrategias pedagógicas en la formación de enfermeros. La población estuvo formada por 37 estudiantes del segundo y tercer periodo del programa de pregrado de enfermería. Las actividades se desarrollaron en tres etapas principales: 1) Participación en Ciclos de Debate; 2) Clases sobre Estrategias Pedagógicas; y 3) Preparación y Presentación de Intervenciones. Resultados: El desarrollo de estrategias pedagógicas por parte de los estudiantes, reveló un esfuerzo significativo para enfrentar los desafíos asociados al uso abusivo de alcohol y otras drogas. La elección predominante de tecnologías digitales, como apps y sitios web, pone de manifiesto una tendencia creciente a incorporar recursos tecnológicos en la educación e intervención en salud, reflejando la evolución de las prácticas pedagógicas y la adaptación a las necesidades contemporáneas. Conclusión:El enfoque metodológico adoptado, que incluyó la participación en ciclos de debate, la aplicación de metodologías activas y el desarrollo de tecnologías digitales, puso de relieve la capacidad de los estudiantes para crear soluciones educativas pertinentes y adaptadas a las necesidades contemporáneas.

A necessidade de estratégias para o enfrentamento do uso abusivo de susbtâncias revela a urgência de reformular modelos assistenciais. O artigo relata a experiência pedagógica dos estudantes do curso de graduação em Enfermagem no desenvolvimento de saberes alinhados às necessidades dos usuários de álcool e outras drogas. Método: Relato de experiência que objetiva refletir sobre estratégias pedagógicas na formação de Enfermeiros. A população consistiu em 37 estudantes do segundo e terceiro períodos do curso de graduação em Enfermagem. As atividades foram desenvolvidas em três etapas principais: Participação em Ciclos de Debate; 2) Aulas com o tema Estratégias Pedagógicas e; Elaboração e Apresentação de Intervenções. Resultados: O desenvolvimento de estratégias pedagógicas pelos estudantes, revelou um esforço significativo para enfrentar os desafios associados ao uso abusivo de álcool e outras drogas. A escolha predominante por tecnologias digitais, como aplicativos e sites, destaca uma tendência crescente de incorporar recursos tecnológicos na educação e intervenção em saúde, refletindo a evolução das práticas pedagógicas e a adaptação às necessidades contemporâneas. Conclusão:A abordagem metodológica adotada, que incluiu a participação em ciclos de debate, a aplicação de metodologias ativas e o desenvolvimento de tecnologias digitais, evidenciou a capacidade dos discentes de criar soluções educacionais relevantes e adaptadas às necessidades contemporâneas.

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INTRODUCTION: Problematic Internet use has become a growing problem worldwide; several factors, including personality, play an essential role in understanding this disorder. The Big Five personality traits and their association with problematic Internet use were examined in a large and diverse population. METHODS: A survey was applied to a total of 1,109 adults of working age. Each answered the Big Five Inventory and the Internet Addiction Test. RESULTS: Problematic Internet use was found in 10.6% of them (n=112). The personality traits extraversion and openness to experience were significantly associated with those with the disorder. With adjustment models, a positive association was found between these traits and being single and higher education. CONCLUSIONS: This study represents the largest of its kind in the Spanish-speaking population, highlighting the importance of recognising the factors involved in problematic Internet use.

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Protected areas are typically considered a cornerstone of conservation programs and play a fundamental role in protecting natural areas and biodiversity. Human-driven land-use and land-cover (LULC) changes lead to habitat loss and biodiversity loss inside protected areas, impairing their effectiveness. However, the global dynamics of habitat quality and habitat degradation in protected areas remain unclear. We used the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model based on global annual remotely sensed data to examine the spatial and temporal trends in habitat quality and degradation in global terrestrial protected areas. Habitat quality represented the ability of habitats to provide suitable conditions for the persistence of individuals and populations, and habitat degradation represented the impacts on habitats from human-driven LULC changes in the surrounding landscape. Based on a linear mixed-effects modeling method, we also explored the relationship between habitat degradation trends and protected area characteristics, biophysical factors, and socioeconomic factors. Habitat quality declined by 0.005 (0.6%) and habitat degradation increased by 0.002 (11%) from 1992 to 2020 globally, and similar trends occurred even in remote or restrictively managed protected areas. Habitat degradation was attributed primarily to nonirrigated cropland (62%) and urbanization (27%) in 2020. Increases in elevation, gross domestic production per capita, and human population density and decreases in agricultural suitability were associated with accelerated habitat degradation. Our results suggest that human-induced LULC changes have expanded from already-exploited areas into relatively undisturbed areas, and that in wealthy countries in particular, degradation is related to rapid urbanization and increasing demand for agricultural products.

Tendencias en la calidad y degradación del hábitat en áreas protegidas terrestres Resumen Las áreas protegidas suelen considerarse la piedra angular de los programas de conservación y desempeñan un papel fundamental en la protección de los espacios naturales y la biodiversidad. Los cambios en el uso y la cobertura del suelo (CUCS) provocados por el hombre conducen a la pérdida de hábitats y de biodiversidad dentro de las áreas protegidas, lo que merma su eficacia. Sin embargo, la dinámica global de la calidad y la degradación del hábitat en las áreas protegidas sigue sin estar clara. Utilizamos el modelo de valoración integrada de servicios ambientales y compensaciones (InVEST), basado en datos anuales mundiales obtenidos por teledetección, para examinar las tendencias espaciales y temporales de la calidad y degradación del hábitat en las áreas terrestres protegidas de todo el mundo. La calidad del hábitat representó su capacidad para proporcionar condiciones adecuadas para la persistencia de individuos y poblaciones, y la degradación del hábitat representó los impactos sobre los hábitats de los cambios CUCS provocados por el hombre en el paisaje circundante. Con base en un método de modelo lineal de efectos mixtos, también exploramos la relación entre las tendencias de degradación del hábitat y las características de las áreas protegidas, los factores biofísicos y los factores socioeconómicos. La calidad del hábitat disminuyó en un 0.005 (0,6%) y la degradación del hábitat aumentó en un 0.002 (11%) entre 1992 y 2020 a nivel mundial, y se produjeron tendencias similares incluso en áreas protegidas remotas o gestionadas de forma restrictiva. La degradación del hábitat se atribuyó principalmente a las tierras de cultivo sin irrigación (62%) y a la urbanización (27%) en 2020. El aumento de la altitud, del producto interno bruto per cápita y de la densidad de población humana, así como la disminución de la idoneidad agrícola, se asociaron a una aceleración de la degradación del hábitat. Nuestros resultados sugieren que los cambios en el CUCS inducidos por el hombre se han extendido desde zonas ya explotadas a zonas relativamente inalteradas, y que, en particular en los países ricos, la degradación está relacionada con la rápida urbanización y la creciente demanda de productos agrícolas.

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Opioid use disorder (OUD) among pregnant people has increased dramatically during the opioid epidemic, affecting a significant number of families with young children. Parents with OUD commonly face significant challenges as they are often balancing the stress of caring for young children with maintaining recovery and co-occurring psychosocial challenges (e.g., mental health, low social support). Toward designing interventions to address parenting needs among parents with OUD, we conducted a mixed-methods study to understand the acceptability of receiving parenting support prenatally among pregnant people with OUD residing in the United States. Semi-structured interviews were conducted among 18 pregnant and early postpartum people recruited from a substance use treatment program specializing in the care of pregnant and parenting populations. Among all participants, a prenatal parenting program that comprehensively addresses recovery, parenting, and wellbeing was found to be widely acceptable. Regarding content most desirable within a parenting intervention, participants indicated an interest in breastfeeding, caring for newborns with in-utero opioid exposure, parent-infant bonding, infant soothing techniques, their own wellbeing/mental health, and parenting skills. We introduce a prenatal adaptation of the well-established Family Check-up parenting intervention as a novel, prenatal intervention to prevent negative outcomes for caregivers in recovery and their children.

El trastorno de uso de Opioides (OUD) entre personas embarazadas ha aumentado dramáticamente durante la epidemia de opioides, lo cual afecta a un número significativo de familias con niños pequeños. Los progenitores con OUD comúnmente enfrentan retos significativos ya que ellos a menudo buscan equilibrar el estrés de cuidar a niños pequeños con mantener la recuperación y retos sicosociales concurrentes (v.g. salud mental, bajo apoyo social). Con miras al diseño de intervenciones que se ocupen de las necesidades de crianza entre progenitores con OUD, llevamos a cabo un estudio con métodos combinados para comprender el nivel de aceptación de recibir apoyo de crianza prenatalmente entre personas embarazadas con OUD residentes en Estados Unidos. Se llevaron a cabo entrevistas semiestructuradas con 18 personas embarazadas y en el estado temprano del postparto reclutadas de un programa de tratamiento por uso de sustancias que se especializa en el cuidado de grupos de población en estado de embarazo y de crianza. Entre todos los participantes, se notó la amplia aceptación de un programa prenatal de crianza que de manera comprensiva se ocupa de la recuperación. Con respecto al contenido más adecuado dentro de una intervención de crianza, los participantes indicaron su interés en amamantar, cuidar de los recién nacidos expuestos a opioides en el útero, la unión afectiva entre progenitor e infante, técnicas para calmar al infante, su propio bienestar/salud mental, así como las habilidades de crianza. Introdujimos una adaptación prenatal de la bien establecida intervención de crianza Family Check­Up (El Chequeo de Familia) como una novedosa intervención prenatal para prevenir resultados negativos para cuidadores en proceso de recuperación y sus niños.

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En la relación de pareja, el empleo del celular puede llegar a ocasionar conflictos, lo que afectaría la valoración de la unión conyugal. Objetivo: Determinar la asociación entre la satisfacción con la relación de pareja y los conflictos por el uso del celular en adultos peruanos. Materiales y Métodos. Estudio cuantitativo, de tipo no experimental, transversal y correlacional. La muestra fue constituida por 325 adultos peruanos mediante un muestreo no probabilístico. La información se recolectó mediante la técnica de la encuesta y como instrumento dos cuestionarios, la Escala de Valoración de la Relación propuesto por Hendrick y la Escala de Conflictos Relacionados al uso del celular de Roberts y David. Resultados. La satisfacción con la relación de pareja fue mayormente moderada para el 43,5%. Entre tanto, indicaron algún nivel de conflicto por el uso del celular el 72,9%. Además, no se encontró diferencias significativas en la satisfacción con la relación de pareja según el sexo. Conclusiones. Existe relación negativa moderada y significativa entre la satisfacción con la relación de pareja y los conflictos por el uso del celular en adultos peruanos (rs= -0.456), donde se alcanzó una p=0,000 (<0.05). De esta manera se sostiene que a mayor satisfacción, menores serán los conflictos percibidos por el uso del celular.

In the couple relationship, the use of cell phones can lead to conflicts, which would affect the assessment of the marital union. Objective: To determine the association between satisfaction with the couple relationship and conflicts due to cell phone use in Peruvian adults. Materials and Methods. Quantitative, non-experimental, cross-sectional and correlational study. The sample consisted of 325 Peruvian adults through non-probabilistic sampling. The information was collected using the survey technique and two questionnaires as instruments, the Relationship Assessment Scale proposed by Hendrick and the Conflicts Related to Cell Phone Use Scale by Roberts and David. Results. Satisfaction with the couple relationship was mostly moderate at 43.5%. Meanwhile, 72.9% indicated some level of conflict due to cell phone use. Furthermore, no significant differences were found in satisfaction with the couple relationship according to sex. Conclusions. There is a moderate and significant negative relationship between satisfaction with the couple relationship and conflicts due to cell phone use in Peruvian adults (rs= -0.456), where p=0.000 (<0.05) was reached. In this way, it is argued that the greater the satisfaction, the fewer the perceived conflicts due to cell phone use.

No relacionamento conjugal, o uso de celulares pode levar a conflitos, o que afetaria a avaliação da união conjugal. Objetivo: Determinar a associação entre a satisfação com o relacionamento conjugal e os conflitos devido ao uso de celular em adultos peruanos. Materiais e Métodos. Estudo quantitativo, não experimental, transversal e correlacional. A amostra foi constituída por 325 adultos peruanos através de amostragem não probabilística. As informações foram coletadas utilizando a técnica de survey e dois questionários como instrumentos, a Escala de Avaliação de Relacionamento proposta por Hendrick e a Escala de Conflitos Relacionados ao Uso de Celular de Roberts e David. Resultados. A satisfação com o relacionamento conjugal foi predominantemente moderada em 43,5%. Enquanto isso, 72,9% indicaram algum nível de conflito devido ao uso de celular. Além disso, não foram encontradas diferenças significativas na satisfação com o relacionamento conjugal de acordo com o sexo. Conclusões. Existe uma relação negativa moderada e significativa entre a satisfação com o relacionamento conjugal e os conflitos devido ao uso de celular em adultos peruanos (rs= -0,456), onde foi atingido p=0,000 (<0,05). Dessa forma, argumenta-se que quanto maior a satisfação, menores serão os conflitos percebidos devido ao uso de celular.

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OBJECTIVE: To analyze the prescription of drugs to aid smoking cessation and to detect whether there are differences by age or sex. DESIGN: Retrospective cohort study. SITE: Zamora Health Area. PARTICIPANTS: Persons with smoking cessation attempts employing drugs funded in the period from 2020 to 2023. INTERVENTIONS: Request of pharmaceutical consumption of varenicline, bupropion and cytisine to the Pharmacy Information System of the Regional Health Management of Castilla y León. MAIN MEASUREMENTS: Number of quit attempts per person, treatment drug, number of medication containers per attempt, year, age and sex. Descriptive and statistical analysis using SPSS© v. 20. RESULTS: 2581 people tried to quit smoking with drugs, 2206 made one attempt and 375 made several attempts. Mean age was 50.7 years (95% CI: 50.2-51.1). No significant differences were found for age (P=.71) or sex (P=.74). There was a preference for prescribing varenicline over bupropion and low drug compliance, with only one container of medication being collected in about 50% of cases. A total of 1680 attempts were made to quit using cytisine in 2023, equivalent to 55.4% of the total number of treatment drugs used in the four years. The estimated cumulative incidence rate of drug withdrawal attempts in smokers between 18 and 65 years of age was 11.9%. CONCLUSIONS: The drug intervention had a low reach and poor compliance with the recommended treatment. It is essential to emphasize patient follow-up and drug adherence.

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Atopic dermatitis (AD) is a chronic, inflammatory skin disease affecting all age groups, particularly children. This systematic review provides an overview of the humanistic and economic disease burden in the pediatric population with AD in Spain. The evidence, collected from 11 observational studies published over the past 10 years, exhibits the most common characteristics of the patients, disease burden, patient-reported outcomes, use of resources, and treatment patterns. The burden of AD extends beyond physical symptoms, with associated comorbidities such as asthma and impaired health-related quality of life and mental health disorders, particularly in severe cases. Traditional therapies, primarily topical corticosteroids, face adherence and efficacy challenges. Despite promising innovative treatments and available biological therapies, their use is still limited in the pediatric population. The findings of the present review highlight the scarce scientific evidence on the economic burden of pediatric AD, as well as the most updated humanistic evidence on this disease. At the same time, the need for individualized care and innovative therapeutic interventions to address the multifaceted challenges of pediatric AD in Spain is evident.

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Effects of anthropogenic activities, including climate change, are modifying fire regimes, and the dynamic nature of these modifications requires identification of general patterns of organisms' responses to fire. This is a challenging task because of the high complexity of factors involved (including climate, geography, land use, and species-specific ecology). We aimed to describe the responses of the reptile community to fire across a range of environmental and fire-history conditions in the western Mediterranean Basin. We sampled 8 sites that spanned 4 Mediterranean countries. We recorded 6064 reptile sightings of 36 species in 1620 transects and modeled 3 community metrics (total number of individuals, species richness, and Shannon diversity) as responses to environmental and fire-history variables. Reptile community composition was also analyzed. Habitat type (natural vs. afforestation), fire age class (time since the last fire), rainfall, and temperature were important factors in explaining these metrics. The total number of individuals varied according to fire age class, reaching a peak at 15-40 years after the last fire. Species richness and Shannon diversity were more stable during postfire years. The 3 community metrics were higher under postfire conditions than in unburned forest plots. This pattern was particularly prevalent in afforested plots, indicating that the negative effect of fire on reptiles was lower than the negative effect of afforestation. Community composition varied by fire age class, indicating the existence of early- and late-successional species (xeric and saxicolous vs. mesic reptiles, respectively). Species richness was 46% higher in areas with a single fire age class relative to those with a mixture of fire age classes, which indicates pyrodiverse landscapes promoted reptile diversity. An expected shift to more frequent fires will bias fire age distribution toward a predominance of early stages, and this will be harmful to reptile communities.

Respuestas de reptiles al fuego en la Cuenca Mediterránea occidental Resumen Los efectos de actividades antropogénicas, incluyendo el cambio climático, están modificando los regímenes de fuego, y la naturaleza dinámica de estas modificaciones requiere la identificación de patrones generales de las respuestas de los organismos al fuego. Esta es una tarea desafiante debido a la gran complejidad de los factores involucrados (incluyendo clima, geografía, uso de suelo y la ecología de cada especie). Nuestro objetivo fue describir las respuestas de la comunidad de reptiles al fuego bajo diversas condiciones ambientales e historias de fuego en la Cuenca Mediterránea occidental. Muestreamos ocho sitios en cuatro países mediterráneos. Registramos 6064 avistamientos de reptiles de 36 especies en 1620 transectos y modelamos tres métricas comunitarias (número total de individuos, riqueza de especies y diversidad de Shannon) como respuestas a las variables ambientales y de historia de fuego. También analizamos la composición de la comunidad de reptiles. El tipo de hábitat (natural versus forestación), la clase de edad del fuego (tiempo transcurrido desde el último incendio), la precipitación pluvial y la temperatura fueron factores importantes en la explicación de estas métricas. El número total de individuos varió de acuerdo con la clase de edad del fuego, alcanzando un pico a los 15­40 años después del último incendio. La riqueza de especies y la diversidad de Shannon fueron más estables durante los años posteriores a incendios. Las tres métricas de la comunidad fueron más altas bajo condiciones post incendio que en las parcelas sin historial de fuego. Este patrón fue particularmente prevalente en parcelas forestadas, lo cual indica que el efecto negativo del fuego sobre los reptiles fue menor que el efecto negativo de la forestación. La composición de la comunidad varió por clase de edad del fuego, indicando la existencia de especies sucesionales tempranas y tardías (reptiles xéricos y saxícolas, respectivamente). La riqueza de especie fue 46% mas alta en áreas con una sola clase de edad del fuego que en aquellas con una mezcla de clases de edad del fuego, lo cual indica que los paisajes pirodiversos promovieron la diversidad de reptiles. Un cambio esperado hacia incendios más frecuentes sesgará la distribución de la edad del fuego hacia una predominancia de etapas tempranas, y esto será perjudicial para las comunidades de reptiles.

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Alcoholics Anonymous (AA) is an established resource for people suffering from alcohol use disorder (AUD). However, Bill Wilson, the co-founder of AA, in his second letter to Jung referred to its low success rate. One evidence-based alternative, dating back to the 1950s, is the clinical use of lysergic acid diethylamide (LSD) for treating AUD. Bill Wilson was a strong advocate of using LSD as a preparation for alcoholics who had difficulty grasping the spiritual aspect of the 12-step programme. Bill Wilson wrote a "secret" four-page letter to Carl Jung detailing his own use of LSD and the success two psychiatrists in Canada had in treating alcoholics and asked for his advice on using LSD to help alcoholics. Aniela Jaffé, a Jungian analyst and co-worker of Jung, replied to Wilson on May 29, 1961, "… as soon as Dr. Jung feels better and has enough strength to begin again his mail, I will show it to him." Jung died a week later. This article quotes Jung's previous hostile opinions on psychedelics and asks: Just as Jung overcame his negative views on groups when giving "complete instructions" on extending the 12-step programme of AA to "general neurotics", might he similarly have changed his mind when he saw the documented success of using LSD with recalcitrant alcoholics?

Alcooliques Anonymes (A.A.) est une ressource reconnue pour les personnes souffrant du Trouble de l'Usage de l'Alcool (TUA). Bill Wilson, co­fondateur des AA, dans sa deuxième lettre à Jung, a fait référence à son faible taux de réussite. Une alternative fondée sur des preuves, et qui remonte aux années 1950, est l'utilisation médicale de l'acide lysergique diéthylamide (LSD) pour le traitement du TUA. Bill Wilson a fortement préconisé l'utilisation du LSD pour la préparation des alcooliques qui avaient des difficultés à saisir l'aspect spirituel du programme en douze étapes. Bill Wilson écrivit à Carl Jung une lettre de quatre pages, « secrète ¼, exposant en détails sa propre utilisation du LSD et le succès de deux psychiatres canadiens dans le traitement de personnes alcooliques avec le LSD. Il demandait conseil à Jung sur l'utilisation du LSD pour aider les alcooliques. Aniela Jaffé, une analyste jungienne et collaboratrice de Jung répondit à Wilson le 29 mai 1961 : « … dès que le Dr Jung se sentira mieux et aura suffisamment de force pour recommencer à s'occuper de son courrier, je lui montrerai. ¼ Jung est mort une semaine plus tard. Cet article cite les opinions antérieures négatives de Jung concernant les drogues psychédéliques et pose la question suivante: tout comme Jung avait dépassé ses perspectives négatives sur les groupes en donnant des « instructions complète ¼ sur l'extension du programme en douze étapes pour les « névrosés de base ¼, aurait­il de la même manière changé d'avis s'il avait vu les résultats probants de l'utilisation du LSD avec les alcooliques récalcitrants?

Alcohólicos Anónimos (A.A.) es un recurso establecido para las personas que padecen Trastorno por Consumo de Alcohol (AUD). Sin embargo, Bill Wilson, cofundador de AA, en su segunda carta a Jung se refirió a su baja tasa de éxito. Una alternativa basada en la evidencia, que se remonta a la década de 1950, es el uso clínico de la dietilamida del ácido lisérgico (LSD) para tratar el AUD. Bill Wilson era un firme defensor del uso del LSD como preparación para los alcohólicos que tenían dificultades para captar el aspecto espiritual del programa de 12 pasos. Bill Wilson escribió una carta "secreta" de cuatro páginas a Carl Jung en la que detallaba su propio uso del LSD y el éxito que habían tenido dos psiquiatras en Canadá en el tratamiento de alcohólicos con LSD y le pedía consejo a Jung sobre el uso del LSD para ayudar a los alcohólicos. Aniela Jaffé, analista Junguiana y compañera de trabajo de Jung, respondió a Wilson el 29 de mayo de 1961: "…tan pronto como el Dr. Jung se sienta mejor y tenga fuerzas suficientes para mirar de nuevo su correo, se lo mostraré". Jung murió una semana después. Este artículo cita las anteriores opiniones hostiles de Jung sobre los psicodélicos y pregunta: Del mismo modo que Jung superó sus opiniones negativas sobre los grupos al dar "instrucciones completas" sobre la extensión del programa de 12 pasos de A.A. a los "neuróticos en general", ¿podría haber cambiado de opinión de forma similar cuando vio el éxito documentado del uso del LSD con alcohólicos recalcitrantes?

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Objective. Understand the motivations and expectations of pregnant women using psychoactive substances during prenatal care. Methods. A qualitative study developed in the light of Alfred Schütz's Theoretical Framework of Phenomenological Sociology, in which 25 pregnant women using psychoactive substances, belonging to a Family Health Strategy, participated. Data production took place between August and November 2022.Results. Two units of meanings emerged: (i) social influences for the performance of prenatal care and (ii) expectation regarding the care to be received by the health professional. Pregnant women do pre-natal due to family influences, for fear of losing their children due to loss of guardianship and concern about the well-being and development of the baby. And, the expectations are that they receive good attention, feel safe when they are attended to by health professionals and also that they are understood and have a relationship of trust. Conclusion. Pregnant women who use psychoactive substances bring motivations for prenatal care linked to the past, such as influences from family members and previous experiences. As for expectations, they are related to the child's health and the care expected by professionals. Finally, strategies to reduce harm during pregnancy of users of psychoactive substances are fundamental for the effectiveness of care.

Objetivo. Conocer las motivaciones y expectativas de las gestantes consumidoras de sustancias psicoactivas durante la atención prenatal. Método. Se trata de un estudio cualitativo basado en el marco teórico de la sociología fenomenológica de Alfred Schütz, en el que participaron 25 gestantes consumidoras de sustancias psicoactivas pertenecientes a una Estrategia de Salud Familiar de una unidad de salud en Brasil. Los datos se recogieron entre agosto y noviembre de 2022. Resultados. Emergieron dos unidades de significado: (i) influencias sociales para la atención prenatal y (ii) expectativas sobre la atención recibida por el profesional de salud. Las gestantes acuden al control prenatal por influencias familiares, miedo a separarse de sus hijos por pérdida de la tutela y preocupación por el bienestar y desarrollo del bebé. Sus expectativas son recibir una buena atención, sentirse seguras con los profesionales sanitarios y ser comprendidas y escuchadas a través de una relación de confianza. Conclusión. Las embarazadas usuarias de sustancias psicoactivas tienen motivaciones para el cuidado prenatal relacionadas con su pasado, como influencias familiares y experiencias individuales previas. En cuanto a las expectativas, están relacionadas con la salud del niño y los cuidados esperados que les brindarán los profesionales de salud. Por último, el diseño de estrategias para reducir los daños durante el embarazo de las consumidoras de sustancias psicoactivas es fundamental para un cuidado eficaz.

Objetivo. Compreender as motivações e expectativas de gestantes usuárias de substâncias psicoativas durante a realização do pré-natal. Métodos. Estudo de abordagem qualitativa desenvolvida à luz do referencial Teórico da Sociologia fenomenológica de Alfred Schütz, em que participaram 25 gestantes usuárias de substâncias psicoativas, pertencentes a uma Estratégia Saúde da Família. A produção de dados ocorreu entre os meses de agosto a novembro de 2022.Resultados. Emergiram duas unidades de significados: (i) influências sociais para a realização do pré-natal e (ii) expectativa em relação ao cuidado a ser recebido pelo profissional de saúde. As gestantes realizam o pré-natal por influências de familiares, por receio de afastamento dos filhos decorrente de perda da tutela e pela preocupação com o bem-estar e desenvolvimento do bebê. E, as expectativas é de que recebam um bom atendimento, sintam segurança nos profissionais de saúde e que sejam compreendidas e ouvidas por meio de uma relação de confiança. Conclusão. As gestantes usuárias de substâncias psicoativas trazem motivações para a realização do pré-natal atreladas ao passado, como influências de familiares e experiências prévias. Quanto as expectativas, estão relacionadas à saúde da criança e o cuidado esperado pelos profissionais. Por fim, as estratégias para reduzir danos durante a gestação de usuárias de substâncias psicoativas é fundamental para a efetividade do cuidado.

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Ethnobotany approached through ethnoeducation allows for the preservation of the cultural heritage of indigenous communities. In this way, the ethnobotanical knowledge of primary school students from the Paniquita Indigenous Community was recognized, regarding the cultural knowledge of medicinal plants and their significance in the conservation of the biocultural heritage. This research had a qualitative, ethnographic approach. The sample consisted of ten students who were part of a focus group, ethnobotanical walks, and participatory workshops with drawings since they stimulate students' creative and dynamic thinking and strengthen interculturality. Twenty-one plants were reported, which are used to relieve sore throats, headaches, and stomach aches, as well as to treat diarrhea and fever, to prevent flu, and as a purgative. All the medicinal plants mentioned grow in the community and are either cultivated or wild, which also shows the students' knowledge of the ir territory. These findings reflect the importance of ethno-education and ethnobotany at school and how historical reconstruction processes are generated from these settings, where indigenous ancestral knowledge is made visible.

La etnobotánica abordada desde la etnoeducación permite mantener el legado cultural de los pueblos originarios. De esta manera, se reconoció el conocimiento etnobotáni co de los estudiantes de primaria de la Comunidad Indígena Paniquita, sobre el conocimiento cultural de las plantas medicinales y su importancia para la conservación del patrimonio biocultural. La investigación tuvo un enfoque cualitativo y etnográfico. La muestra estuvo conformada por diez estudiantes que formaron parte de un grupo focal, caminatas etnobotánicas y talleres participativos con dibujos, ya que estimulan el pensamiento creativo y dinámico de los estudiantes y fortalecen la interculturalidad. Se reportaron 21 plantas que se utilizan para aliviar dolores de garganta, cabeza y estómago, así como para tratar la diarrea y la fiebre, para prevenir la gripe y como purgante. Todas las plantas medicinales mencionadas crecen en la comunidad y son cultivadas o silvestres, lo que también demuestra el conocimiento que los estudiantes tienen de su territorio. Estos hallazgos reflejan la importancia de la etnoeducación y la etnobotánica en la escuela y cómo se generan procesos de reconstrucción histórica desde estos escenarios, donde se visibiliza el conocimiento ancestral indígena.

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OBJECTIVE: To determine the prevalence of PIMDINAC criteria and to implement pharmacological interventions in a population with multiple sclerosis over 55 years of age. METHODS: Retrospective, observational, open-label study, including patients with multiple sclerosis aged 55 years and older during December 2022 and February 2023. The main variable determined was the percentage of compliance with the PIMDINAC criteria. RESULTS: Ninety-five patients were included, with the presence of PIMDINAC criteria detected in 67.4%. The most frequently detected criterion was non-adherence to concomitant treatment (84.4%), followed by drug-drug interactions (56.2%) and potentially inappropriate medication (25%). A total of 20 pharmaceutical interventions were performed in 17 patients (17.9%). Potentially inappropriate medication was responsible for 11 interventions, non-adherence for 7, and drug-drug interactions for 2. The 81.8% of interventions were accepted, resulting in the discontinuation of 15 inappropriately prescribed drugs. The prevalence of PIMDINAC criteria in this group of patients is high. The study revealed that PIMDINAC criteria were prevalent in 67.4% of the study population, with polypharmacy playing an important role, suggesting the potential for a multidisciplinary approach, through pharmaceutical interventions to address unnecessary or duplicate treatments.

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Background: Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD).Objective: This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD.Method: Participants (N = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age.Results: Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD.Conclusions: These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.

All types of Childhood Maltreatment are associated with PTSD severity.Emotional Abuse and Sexual Abuse are most predictive for PTSD severity.Emotional Abuse is most predictive for CPTSD classification and symptom severity.

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INTRODUCTION: This study aimed to present real-life data on the use, efficacy, and safety of administering antibiotic therapy through portable elastomeric pumps (pEP) in the outpatient setting. METHODS: This retrospective observational cohort study was conducted from January 2020 to May 2023 in a large academic hospital in Rome, Italy. All patients receiving antibiotic therapy via pEP were included up to a follow-up period of 90 days after the end of antibiotic therapy. The primary outcome was the treatment response. Secondary endpoints were adverse events attributable to the drug administered, the vascular catheter, or the infection itself. RESULTS: Of the 490 patients referred to our outpatient parenteral antibiotic therapy (OPAT) unit, 94 (19.2%) received antibiotic therapy via pEP and were included in the final analysis. The most frequently treated infections were those involving bone and prosthetics, including spondylodiscitis (n=27; 28.8%). Most infections were due to Pseudomonas aeruginosa (n=55; 48.3%). Cefepime (n=32; 34.0%), piperacillin/tazobactam (n=29; 30.9%), ceftolozane/tazobactam (n=7; 7.5%), and oxacillin (n=7; 7.5%) were the most frequently administered antibiotics. The infection cure rate reached 88.3% (n=83). 12 patients (12.8%) reported adverse events, of which half (6.4%) were drug-related and half (6.4%) were line-related. CONCLUSIONS: OPAT through portable elastomeric infusion pumps proved to be safe and effective. It also contributed to the reduction of healthcare costs, fully respecting the principles of personalized medicine. This strategy has emerged as a promising tool for antibiotic stewardship and infection control.

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RESUMO Os benzodiazepínicos, medicamentos mais prescritos no mundo, são extremamente úteis no manejo de patologias relativas ao sistema nervoso central, porém, nem sempre sua prescrição está relacionada com uma patologia. Este estudo buscou identificar os fatores influenciadores na prescrição de benzodiazepínicos na Atenção Básica do Sistema Único de Saúde e suas consequências, em uma região com alta vulnerabilidade social. Foram utilizados os princípios de um estudo qualitativo com amostra intencional de médicos prescritores construída com a ajuda dos Informantes-Chave e com tamanho (n = 10) definido pelo princípio da saturação teórica. A coleta de dados ocorreu mediante entrevistas semiestruturadas nas unidades básicas onde os profissionais atuavam. Os temas identificados relativos aos motivos da prescrição foram: relativos ao paciente (demanda do paciente; problemas sociais); relativos ao medicamento (dependência); relativos ao prescritor (uso irracional). A prescrição do benzodiazepínico deu-se devido às baixas condições sociais dos usuários nessa região e as consequências dessa conjuntura (vulnerabilidade social, problemas angustiantes de difícil resolução). Educação permanente para profissionais, ações interprofissionais e integralidade do cuidado foram demandas dos profissionais. O problema extrapola a ação do médico, e são sugeridas políticas públicas que garantam, às populações com essas características, acesso a saúde, trabalho e educação.

ABSTRACT Benzodiazepines, the most prescribed medications in the world, are extremely useful in managing conditions related to the central nervous system, however, their prescription is not always related to a pathology. This study sought to identify the factors influencing the prescription of benzodiazepines in Primary Care of the Unified Health System and their consequences, in a region with high social vulnerability. The principles of a qualitative study with intentional sampling of prescribing physicians were used, constructed with the help of Key Informants and with a size (N=10) defined by the principle of theoretical saturation. Collection took place through semi-structured interviews in the basic units where the professionals worked. The themes identified regarding the reasons for prescription were Patient-related (patient demand; social problems); Relating to medication (dependence); Relative to the prescriber (irrational use). The prescription of benzodiazepine was due to the low social conditions of users in this region and the consequences of this situation (social vulnerability, distressing problems with difficult resolution). Continuous education for professionals, interprofessional actions, and comprehensive care were demands of the professionals. The problem goes beyond the doctor's scope of action, and public policies that guarantee such populations access to health, work, and education are suggested.