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Positive sentiments towards urban green spaces (UGS) unequivocally increased worldwide amid COVID-19. In contrast, this paper documents that views on mobility restrictions applicable to UGS are of a contested nature. That is, while residents unambiguously report positive sentiments towards UGS, they do not share views on how to administer access to UGS-which is a matter of public policy. These contesting views reflect opposite demands that managers of UGS had to balance during the pandemic as they faced the challenge of reducing risk of spread while providing services that support physical and mental health of residents. The empirical analysis in this paper relies on views inferred through a text classification algorithm implemented on Twitter messages posted from January to October 2020, by urban residents in three Latin American countries-Argentina, Colombia, and Mexico-and Spain. The focus on Latin America is motivated by the documented lack of compliance with mobility restrictions; Spain works as a comparison point to learn differences with respect to other regions. Understanding and following in real-time the evolution of contesting views amid a pandemic is useful for managers and city planners to inform adaptation measures-e.g. communication strategies can be tailored to residents with specific views.

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Urban green spaces' well documented role as a hub for physical and mental health was enhanced by restrictions to mobility issued worldwide as a response to COVID-19. In this context, managers of urban green spaces (UGS) were prompted to provide controlled access under impromptu safety protocols. This unprecedented challenge required planning and operational strengths reflecting flexibility, innovation and learning. These management features are essential for an adaptive governance - an underdeveloped research topic within the study of UGS. Using eighteen semi-structured interviews from six countries, we analyze adaptive governance as reflected by UGS managers' responses across Latin America - a region where access to UGS is a matter of public health and of environmental justice. We document responses that can be categorized based on the governance arrangement in place. On one hand, both polycentric and dedicated-management governances have been able to learn through piloting ideas, adapting personnel roles and the function of UGS infrastructure, and adjusting their decision-making process. On the other hand, managers within municipal public services areas - the most prevalent governance arrangement across Latin America - report difficulty to adapt - likely due to their dependence on political will, limited autonomy, insufficient budgets, absence of formal paths to self-funding, shortage of technical know-how, and insufficient citizens' involvement. We discuss implications of UGS adaptive governance in terms of capacity to deal with future public health, climate-related or other types of shocks.

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Commuting is expensive in megacities of emerging economies. By decreasing work-related trips, teleworking may reduce congestion and commuting time. Taking Mexico City's office workers' as case study, this paper reports findings from a discrete choice experiment (DCE) exploring willingness to see a cut in monthly paycheck in exchange for teleworking two days a week from a shared office. This DCE explores preferences for bike parking spaces at shared office's facilities, and walking commuting time to shared office. This design allows estimation of willingness to pay (WTP) for teleworking across commuting time scenarios. Monthly WTP for teleworking 2 days a week starts at (2019) USD 76.68-if commuting time is zero. As 1 h of commuting time is valued at USD 61.97 on a monthly basis, WTP for teleworking 30 min away from home is USD 45.69. Wealthier respondents report higher value for commuting time and WTP for teleworking. Monthly value of bike parking infrastructure is USD 14.70-reaching USD 30.98 for commuters that walk or (motor-)bike less than 50 min. We illustrate how these stated benefits can inform cost-benefit analysis of transportation, housing, and labor policies that enable teleworking and/or reduce commuting times in Mexico City.

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UNLABELLED: This study investigated whether osteoporosis/osteopenia has an influence on the progression of periodontitis in postmenopausal women. The findings highlight that postmenopausal women with osteoporosis/osteopenia had a greater chance of presenting periodontitis than those with normal bone mineral density, particularly among nonusers of osteoporosis medications and women with a greater number of remaining teeth, showing that osteoporosis/osteopenia has had an influence on the progression of periodontitis. INTRODUCTION: This study investigated whether osteoporosis/osteopenia has an influence on the progression of periodontitis in postmenopausal women and explored the effects of use of osteoporosis medication and tooth loss on this association. METHODS: This case-control study involved 521 postmenopausal women, with minimum age of 50 years, in Feira de Santana, Bahia, Brazil. Sociodemographic characteristics, health conditions/medications, and lifestyle habits were recorded. A complete periodontal examination was performed and periodontitis was diagnosed. Bone mineral density was evaluated through lumbar spine and femoral bone densitometry, obtained using dual-energy X-ray absorptiometry. Logistic regression was used to calculate the strength of association between the occurrences of osteoporosis/osteopenia and periodontitis. RESULTS: Women with osteoporosis/osteopenia were twice as likely to present periodontitis, as were those with normal bone mineral density, even after adjusting for smoking, age, family income, and last visit to dentist (odds ratios (OR)adjusted=2.24, 95% CI [1.24-4.06], p=0.008). Among nonusers of osteoporosis medication (ORadjusted=2.51, 95% CI [1.33-4.73], p=0.004) and women with at least 10 remaining teeth (ORadjusted=2.50 95% CI [1.18-5.27], p=0.02), the odds ratio was higher and statistically significant. CONCLUSIONS: These findings highlight that postmenopausal women with osteoporosis/osteopenia had a greater chance of presenting periodontitis than those with normal bone mineral density, particularly among nonusers of osteoporosis medications and women with a greater number of remaining teeth.

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UNLABELLED: Data concerning the effects of GnRHa on weight gain are scarce. OBJECTIVE: To assess the variation of the body mass index (BMI) in girls during GnRHa treatment for idiopathic central precocious puberty (CPP). PATIENTS AND METHODS: Semestral anthropometric data from 176 girls treated with goserelin or leuprorelin were analyzed. RESULTS: BMI z-score increased from 1.5 +/- 0.1 SD before treatment (n = 176) to 1.7 +/- 0.2 SD after 24 months (n = 61, p = 0.008). In girls with normal weight before treatment, this variation was greater (n = 112, 0.2 +/- 0.1 SD, p = 0.01) than in those who were overweight (n = 63, -0.9 +/- 0.2 SD, p = 0.7). In the goserelin group the weight change adjusted for bone age was greater (n = 28, 0.4 +/- 0.1 SD) than in the leuprorelin group (n = 5, 0.04 +/- 0.1 SD, p = 0.05). CONCLUSIONS: A slight increase in BMI was noted, mainly in girls with normal weight before treatment. The influence of different GnRHa on weight must be further investigated.

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OBJECTIVE: To present and discuss clinical aspects concerning the most frequent endocrine diseases in adolescents and their effects on physical and psychoaffective fields in affected patients. METHODS: Review of national and international literature combined with the authors own experience with the aim of proposing some guidelines for the management of endocrine diseases in adolescents. RESULTS: The physical and psychological impacts of these diseases on adolescents health may have different intensity. Diabetes mellitus as a chronic, self-limiting disease, with increased risk of late complications, is analyzed in more detail. Thyroid diseases and gynecomastia usually have a milder evolution, but may cause suffering and low self-esteem. CONCLUSIONS: The repercussion of these diseases, especially diabetes mellitus and gynecomastia, on the sexuality of adolescents should be taken into consideration.

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Conditioning for bone marrow transplantation (BMT) by total body irradiation frequently causes growth failure. The contribution of growth hormone (GH) deficiency to this failure was assessed in 38 patients given three types of body irradiation: group 1 (n = 18) was given 12 Gy total body irradiation as six fractions, group 2 (n = 14) 10 Gy (one dose) total body irradiation, and group 3 (n = 6) 6 Gy (one dose) thoracoabdominal irradiation, which did not involve the hypothalamic-pituitary area. At the first evaluation, 2.9 +/- 0.2 (SE) years after BMT, the values for the plasma insulin-like growth factor I (IGF-I) and its GH-dependent binding protein (IGFBP-3) were similar in groups 1 and 2 but significantly greater in group 3 (p < 0.02 for IGF-I and 0.01 for IGFBP-3). These values were similar in those patients in groups 1 and 2 who had low GH peaks after stimulation (12 patients: IGF-I, 0.8 +/- 0.2 U/ml; IGFBP-3, 1.6 +/- 0.2 mg/L) and in those with normal GH peaks (20 patients: 1 +/- 0.1 U/ml and 1.8 +/- 0.1 mg/L). The decrease in height 2 years after BMT was significantly (p < 0.01) greater in group 2 than in groups 1 and 3, but 5 years after BMT it was similar in groups 1 and 2 (0.9 +/- 0.2 and 1.4 +/- 0.3 SD), significantly (p < 0.05) greater in group 2 than in group 3 (0.7 +/- 0.2 SD). The individual height changes between BMT and the last clinical evaluation before GH therapy were not correlated with the age at BMT, GH peak after stimulation, plasma IGF-I concentration, or IGFBP-3 concentration. Seven patients with GH deficiency were given GH therapy; their growth rate became normal for age (-2.1 +/- 0.9 SDS before and -0.2 +/- 0.4 SDS for the first year; not significant) without any catch-up growth. We conclude that plasma IGF-I and IGFBP-3 values are of no diagnostic value for GH deficiency after TBI. Their normal or high levels, despite low GH peaks, suggest that bone irradiation induces lesions causing resistance to IGF-I.

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