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In recent times, forensic science has increasingly relied on methods that use stable and radioactive isotope analysis to identify human remains. The use of 14C-AMS dating of dental enamel and dentine of an individual allows the estimation of the year of birth, while that of stable isotopes of carbon and oxygen can provide information on their geographical origin. Isotopic analysis of a tissue complements existing identification techniques, enhancing the capacity to refine, exclude, and affirm investigative approaches directed towards individual identification.
The primary aim of this exploratory study is to amalgamate diverse isotopic methodologies conducive to the prompt and accurate identification of a deceased individual. In this manuscript, we elucidate the application of a rapid processing technique for whole molars from individuals with documented ages, employed to ascertain age through 14C-AMS dating. Furthermore, an investigation was undertaken to assess the capacity of carbon and oxygen-stable isotopes in distinguishing regional disparities. To achieve this, we conducted a comparative analysis of tooth samples sourced from individuals residing in three cities within the Mexican Republic: Mexico City in the central region, Oaxaca City in the southern region, and Tepic Nayarit on the western Pacific coast. The age of dental piece formation, as estimated through 14C-AMS, exhibited a precise correlation with the actual age. By means of the stable isotope outcomes, the data disclosed substantial disparities in 13C and 18O abundances among teeth from individuals residing in the three cities.
The RedETS horizon scanning (HS) program in Spain is focused on identifying non-pharmaceutical emerging health technologies. HS is organized in three steps: (i) identification using different sources (PubMed, the biomedical press, and others); (ii) screening performed by the HS Working Group and clinicians; and (iii) prioritization using the PriTec tool. This study aimed to evaluate the accuracy of RedETS HS in identifying disruptive emerging technologies for our health system.
Methods
Data from brief files and full reports related to the identified emerging technologies were collected. Full health technology assessment (HTA) reports were also reviewed. The period of analysis was from 2016 to 2023. The information collected included the name, type, category, and indication of the emerging technology and the source of identification. An ad hoc Excel spreadsheet was designed to collect the information. The analysis consisted of a description of the variables and an assessment of concordance between the emerging technologies identified and those with full HTA reports.
Results
There were 338 emerging technologies identified. These technologies were mainly therapeutic (52.1%) or diagnostic (25.7%). In addition, about 45 percent were medical devices and 15.7 percent were in vitro diagnostic tests; imaging comprised 7.4 percent. Most of the emerging technologies were identified through the biomedical press (22.2%), PubMed (23.6%) and industry (20.3%). In a preliminary analysis of these main sources, 31 percent of the technologies identified by HS had full HTA reports, with all of these being identified three years before the HTA.
Conclusions
HS systems might help identify the most relevant technologies for healthcare systems, enabling them to be more ready to incorporate the new technologies. Therefore, HS must be able to detect emerging technologies that will have an impact on the health system. Periodic evaluation of the accuracy of HS programs will improve their impact in the HTA process.
It is widely known that those in the helping professions are mandated to report suspected incidences of child maltreatment. However, few are aware of the historical resistance to mandated reporting that helping professionals demonstrated before the passing of the Child Abuse Prevention and Treatment Act (CAPTA) of 1974 and the associated federal mandates that compelled helping professionals to engage in mandated reporting, oftentimes against their will. By analysing historical policy documents through a grounded theory approach, the authors identified three themes that describe the rationale for the passage of CAPTA: (1) identifying national evidence of child abuse; (2) resistance to intrusion of the helping professional-client relationship; and (3) the necessity of immunity waivers for those who reported instances of child abuse and misdemeanor punishment for those who failed to report such instances. In light of conversations around abolishing or reforming child protective services, it is important to understand how the first federal child protective services policy in the United States originated and how these regulations embedded social control into the foundation of the helping professional-client relationship, thus turning helping professionals into unwilling agents of the state. Implications of mandated reporting, including introducing a penal aspect to the helping professional-client relationship, are also explored.
The aim of this study was to analyse the expression of genes related to the regulation of energy metabolism in skeletal muscle tissue by comparing male offspring in two age groups [at 110 and 245 postnatal days (pnd)] from a mother with obesity induced by a high-fat diet and (-)-epicatechin (Epi) administration. Four groups of six male offspring from different litters were randomly selected for the control groups [C and offspring of mothers with maternal obesity (MO)] or Epi intervention groups. We evaluated the effect of Epi on gastrocnemius tissue by analysing the mRNA and protein expression levels of Fndc5/irisin, Pgc-1α, Ucp3, and Sln. Epi significantly increased the Pgc-1α protein in the MO group of offspring at 110 pnd (p < 0.036, MO vs. MO+Epi), while at 245 pnd, Epi increased Fndc5/irisin mRNA expression in the MO+Epi group versus the MO group (p = 0.006).
No differences were detected in Fndc5/irisin, Ucp3 or Sln mRNA or protein levels (including Pgc-1α mRNA) in the offspring at 110 pnd or in Pgc-1α, Ucp3, or Sln mRNA or protein levels (including Fndc5/irisin protein) at 245 pnd among the experimental groups. In conclusion, (-)-epicatechin treatment increased Fndc5/irisin mRNA expression and Pgc-α protein levels in the gastrocnemius muscle of offspring at postnatal days 110 and 245. Furthermore, it is suggested that the flavonoid effect in a model of obesity and its impact on thermogenesis in skeletal muscle are regulated by a different pathway than Fndc5/irisin.
In times of armed conflict, disasters and violence, people may become separated from their families, go missing or die, or become victims of ill-treatment and sexual violence. Under international humanitarian law, States have obligations to prevent harm and address humanitarian needs. At State level, the medicolegal system is conventionally mandated to address these needs and fulfil related legal obligations. In practice, State responses can sometimes be non-existent, limited by the endemic functionality of existing systems, or degraded by crises of violence, natural disasters and migration. These conditions can, in turn, impede the establishment of peace, reparations, restorative justice efforts and post-conflict reconstruction. This paper explains what a medicolegal system is and the entities that encompass it. The paper highlights the importance of developing clear policies, regulation and procedures that ensure proper functioning of the system. It reviews common gaps and challenges that limit State prevention and response to issues of humanitarian concern. Finally, recommendations when developing and implementing humanitarian programmes to strengthen medicolegal systems are provided, with a particular focus on the content of protection dialogue in diplomatic fora.
Cognitive, motor and sensory deficits associated with aging, and with some neurological conditions such as acquired brain injury, may lead to severe driving performance impairment. While rehabilitation and driver assistance technologies may improve driving performance, the assessment of the actual fitness-to-drive of these people is challenging. Office-based neuropsychological/physical tests are considered insufficient to understand one’s ability to drive. The gold standard is the on-road assessment with dual control cars, superior in ecological validity, but expensive, stressful, and potentially unsafe. Valid, more cost-effective solutions for a safer, more accurate, standardized assessment of fitness-to-drive are currently needed. Modern and sensorized driving simulators offer key advantages, such as the possibility of exposing drivers to several relevant driving scenarios, including hazard situations, and of assessing their driving performance without being physically at risk. However, the extraction and direct interpretation of existing simulator-produced data may require specialized data processing skills or simulation expertise. To overcome this, we have developed an easy-to-use, pencil-and-paper observational instrument. The Sim-DOS is an adaptation of the widely used instrument to assess “natural driving”, the Driving Observation Schedule (DOS; Vlahodimitrakou et al., 2013).
Participants and Methods:
Via expert consensus, DOS targeted behaviors were adapted to a simulated-based environment (signaling, observation of environment, speed regulation, slow or unsafe reaction, distance interpretation, vehicle/lane positioning), and the Sim-DOS scores calculation (based on errors while doing such behaviors) was adapted from DOS to include hazard situations (HS, 0-100) and free driving (FD, 0-°°) scores. The instrument was then piloted with a sample of 35 older adults, along with the collection of simulator-produced data on number of harsh events and driving speed. Participants drove two consecutive 20-minutes long scenarios, with low and high traffic density (LTD, HTD). In each scenario, there were periods with and without potentially hazard situations.
Results:
Assessments were performed by two independent trained observers, producing substantial inter-rater reliability (intra-class correlation coefficients above 0.94). Participants (70.7±4.1 years old, 60% male, 46.1±6.7 years of driving experience) were mostly regular drivers (74%). However, psychomotor skills of the majority were compromised, with only one participant being above the 80th percentile in the reaction times test of the national mandatory driving assessment. When exposed to hazard situations, most of the participants (94.1%) did not perform well, independently of traffic density, with average Sim-DOS-HS scores of 87.1±9.7 (out of 100, t-values>7.3, p-values<.05).
Compared to LTD scenarios, in HTD scenarios participants drove less smoothly (HTD:0.97±1.24 vs. LTD:0.33±0.58 of harsh events, Z=3.1, p<.05). However, they also drove slower (HTD:82.41±27.43 vs. LTD:103.55±14.61 km/h, t=5.2, p<.05), improving their ability to manage hazard situations, and therefore producing higher than expected Sim-DOS scores (HTD:87.05±10.28). During free driving, participants performed worse under LTD conditions (Sim-DOS-FD scores: HTD:11.68±6.20 vs. LTD:14.40±9.58, t=2.15, p<.05) as they drove at higher speed (HTD:85.01±24.28 vs. LTD:104.70±11.94 km/h, t=5.8, p<.05), although they did it more smoothly (HTD:1.94±3.74 vs. LTD:0.45±0.74 harsh events, Z=2.65, p<.05).
Conclusions:
Our study provides a validated driving assessment tool for use in driving simulators that will allow a safer, more ecologic, holistic and informative evaluation of the fitness-to-drive of older adults and neurological patients.
Global neurocognitive impairment (NCI) has been reported in white people living with HIV/AIDS (PLWHA) in 40%. In Latino populations there have been variable rates described from 30 to 77%. This variation has to do with the lack of normative data for Latino population and the application of norms for English-speakers, increasing the probability of misidentification of NCI. Thus, recognizing which are the best norms available for the Mexican population is important for the accurate identification of NCI. The aim of the present study was to investigate the rate and pattern of HIV associated neurocognitive impairment (NCI) and to compare rates of NCI between rates calculated using norms for the Latin-American population (NLAP) and norms for the US-Mexico border region (NP-NUMBRS).
Participants and Methods:
CIOMS international ethical guidelines for the participation of human subjects in health research were followed. 82 PLWHA living in Tijuana (Mexico) participated in the study (Age: Mean=39.6, SD=10.9; 28.3% Female; Years of education: Mean=8.5, SD=3.6). PLWHA were recruited from the board-and-care home “Las Memorias” (73.4% on antiretroviral therapy; Years since HIV diagnosis: Mean=9.9, SD=7.1). Participants completed a neuropsychological test battery sensitive to detect HIV associated NCI that assessed four cognitive domains (verbal fluency, speed of information processing, executive function and learning/memory). Raw scores in these tests were transformed to percentiles using LAPN and transformed to T-scores using NP-NUMBRS. T-scores were averaged across tests to compute domain specific and global impairment scores. NCI was defined as percentile scores <16 and T-scores < 40. McNemar’s tests were used to compare the rate of NCI utilizing NLAP vs NP-NUMBRS.
Results:
According to NLAP, rates of global NCI were about 13.4%. Utilizing NP-NUMBRS rates of global NCI were about 34.1%. However, there is a positive and significant correlation between Global Neurocognitive Function score in PLWHA according to NLAP and NP-NUMBRS (r=0.66, p<.05). Rates of global NCI in PLWHA were significantly lower when using LAP norms (McNemar Chi-Square=29.89; p<.001). Regarding the pattern of NCI according both norms learning and memory was the most affected cognitive domain with 34% of impairment according to NLAP vs 51% of impairment according to NP-NUMBRs.
Conclusions:
Utilizing NP-NUMBRS, rates of NCI are consistent with findings of prior studies. Employing norms for LAP the rates of NCI are lower that the ones reported in the literature. This is an important finding since PLWHA included in the sample have several vulnerable factors such as deportation, prostitution, drug abuse and discrimination for sexual preference, factor that could impact cognition. The pattern of neurocognitive function was also similar to those of prior studies in HIV. To accurately make NCI diagnosis it is important to use norms that consider specific characteristics of the population. The diagnosis of NCI is important since these deficits present a strong risk of concurrent problems in a wide range of health behaviors like medication non-adherence in PLWHA.
La costa del Pacífico de los Andes meridionales tiene una larga historia ocupacional que muestra una diversificación regional hacia el Holoceno medio y tardío. La costa del centro norte de Chile tuvo una importante ocupación cazadora-recolectora entre 6000 y 2000 cal aP, que difiere de las observadas en áreas vecinas por sus características ambientales e históricas. Los estudios de contextos funerarios revelan que estos grupos experimentaron una expansión demográfica y vivieron conflictos sociales durante este período. Sin embargo, el énfasis en la importancia de los contextos funerarios entre 6000 y 2000 cal aP ha limitado nuestro conocimiento de las estrategias medioambientales de estos grupos y el uso de los recursos costeros. Esta investigación examina evidencias recuperadas de contextos residenciales y funerarios del sitio Punta Teatinos (Bahía de Coquimbo, costa centro norte de Chile, 29°S) para evaluar las estrategias de uso ambiental aplicadas. El estudio de estas evidencias —incluyendo estratigrafía, fechados radiocarbónicos, material lítico, malacológico y zooarqueológico; microfósiles, cálculos dentales, isótopos estables y arte rupestre— indican una explotación de recursos costeros, a los que se sumaron otros de origen terrestre. Aunque no se identificaron cambios temporales en la explotación de los recursos costeros, las pruebas también indican cambios en la constitución de los paisajes históricos y de las redes sociales extrarregionales.
Many autistic children experience difficulties in their communication and language skills development, with consequences for social development into adulthood, often resulting in challenges over the life-course and high economic impacts for individuals, families, and society. The Preschool Autism Communication Trial (PACT) intervention is effective in terms of improved social communication and some secondary outcomes. A previously published within-trial economic analysis found that results at 13 months did not support its cost-effectiveness. We modeled cost-effectiveness over 6 years and across four European countries.
Methods
Using simulation modeling, we built on economic analyses in the original trial, exploring longer-term cost-effectiveness at 6 years (in England). We adapted our model to undertake an economic analysis of PACT in Ireland, Italy, and Spain. Data on resource use were taken from the original trial and a more recent Irish observational study.
Results
PACT is cost-saving over time from a societal perspective, even though we confirmed that, at 13 months post-delivery, PACT is more expensive than usual treatment (across all countries) when given to preschool autistic children. After 6 years, we found that PACT has lower costs than usual treatment in terms of unpaid care provided by parents (in all countries). Also, if we consider only out-of-pocket expenses from an Irish study, PACT costs less than usual treatment.
Discussion
PACT may be recommended as a cost-saving early intervention for families with an autistic child.
Autism is a lifelong complex neurodevelopmental condition that affects brain development and behaviour with significant consequences for everyday life. Despite its personal, familial, and societal impact, Europe-wide harmonised guidelines are still lacking for early detection, diagnosis, and intervention, leading to an overall unsatisfactory autistic person and carer journey.
Methods
The care pathway for autistic children and adolescents was analysed in Italy, Spain and the UK from the perspective of carers (using a survey aimed at caregivers of autistic children 0–18 years old), the autistic community, and professionals in order to identify major barriers (treatment gaps) preventing carers from receiving information, support, and timely screening/diagnosis and intervention.
Results
Across all three countries, analysis of the current care pathway showed: long waits from the time carers raised their first concerns about a child’s development and/or behaviour until screening and confirmed diagnosis; delayed or no access to intervention once a diagnosis was confirmed; limited information about autism and how to access early detection services; and deficient support for families throughout the journey.
Conclusions
These findings call for policy harmonisation in Europe to shorten long wait times for diagnosis and intervention and therefore, improve autistic people and their families’ journey experience and quality of life.
This article explores the workings of social and territorial stigma among residents of an stigmatized neighborhood in Santiago de Chile in the context of nationwide conflict. By attending to the narratives of social organizers, it shows how stigma framed the narratives of the Chilean revolt of October 2019 produced by two female organizers older than fifty years without tertiary education. It argues that, for those with less educational and political resources, stigma can help think through a social conflict by translating broader political issues into everyday life experiences and can both constrain and enable different forms of engagement in the revolt. The narratives were obtained by ethnographic interviews carried out in a broader project of the unfolding of the unrest in Santiago’s peripheries between November 2019 and July 2020.
Autism and epilepsy often occur together. Epilepsy and other associated conditions have a substantial impact on the well-being of autistic people and their families, reduce quality of life, and increase premature mortality. Despite this, there is a lack of studies investigating the care pathway of autistic children with co-occurring epilepsy in Europe.
Methods
We analyzed the care pathway for autistic children with associated epilepsy in Italy, Spain, and the United Kingdom from the perspective of caregivers (using a survey aimed at caregivers of autistic children 0–18 years old), the autistic community, and professionals, in order to identify major barriers preventing caregivers and autistic children from receiving timely screening and treatment of possible co-occurring epilepsy.
Results
Across all three countries, an analysis of the current care pathway showed a lack of systematic screening of epilepsy in all autistic children, lack of treatment of co-occurring epilepsy, and inappropriate use of antiepileptic drugs. A major challenge is the lack of evidence-based harmonized guidelines for autism with co-occurring epilepsy in these countries.
Conclusions
Our findings show both heterogeneity and major gaps in the care pathway for autism with associated epilepsy and the great efforts that caregivers must make for timely screening, diagnosis, and adequate management of epilepsy in autistic children. We call for policy harmonization in Europe in order to improve the experiences and quality of life of autistic people and their families.
The welfare of animals in food-production systems is a cause of concern to the public. Regenerative agriculture was first used by the Rodale Institute and proposes to regenerate degraded components of ecosystems, aiming to be more than just sustainable. However, despite animal welfare being pushed to be part of the SDG agenda for 2030, there is no clarity on how regenerative agriculture impacts animal welfare. It is challenging to determine regenerative agriculture impacts on animal welfare, since it is not entirely defined. One Welfare could help define entry points for future research by studying animal welfare in connection with human welfare and environmental conservation. We aimed to analyse the extent to which positive animal welfare outcomes characterise regenerative agriculture systems in peer-reviewed articles and whether the narratives of such articles support that regenerative agriculture promotes animal welfare directly or indirectly by improving human welfare and environmental conservation. We searched papers including ‘regenerative agriculture’ using PRISMA-P, selecting animal welfare, human welfare, environment conservation terms, developed themes, and carried out analysis using Atlas.Ti8 and Causal Loop Diagram. We found that papers mainly linked animal welfare to animal health, human welfare to financial farm status and farmer’s self-awareness, and environmental conservation to soil improvement. Causal Loop Diagram indicated that regenerative agriculture had the potential to improve the health and nutrition components of animal welfare by enhancing financial farmers’ status/self-awareness (human welfare), and the soil (environmental conservation), reflecting that the processes that affect human welfare and environmental conservation could also affect animal welfare. However, information in papers remains insufficient to determine how regenerative agriculture impacts on animal welfare and research into regenerative agriculture needs to extend its focus on animal welfare and elucidate the regenerative agriculture principles leading to animal welfare.
Digeneans have important roles within ecosystems; however, it is estimated that only 14% of the species have been described. Therefore, before being able to detail their role, digenean species’ identification and the diversity present in the ecosystems must be known. In this study, the diversity and the temporal-spatial dynamics of larval digeneans in the freshwater snail Heleobia parchappii were analysed in a shallow lake. Specimens of H. parchappii were collected seasonally at three points during one year and a total of 2871 molluscs were analysed. A total of 23 species of digenea were registered and both the overall prevalence and the composition of the assemblages presented temporal and spatial variations, responding to the differential environmental conditions characteristics (anthropic effect, presence of native forests, and differential use of the habitat by the definitive hosts) of three sampled sites. The assemblages of larval digenean in their first intermediate host support the idea that this area is of great importance in biodiversity, and could be endemic areas of some species of digenean that use reptiles, amphibians and bats as hosts, groups that are at risk of conservation. Protection of these environments is a fundamental pillar in the policies for the conservation of wild flora and fauna.
Massive hemorrhage (MH) is a growing pathology in military settings and increasingly in civilian settings; it is now considered a public health problem in the United States with large-scale programs. Tourniquets are the fastest and most effective intervention in MH if direct pressure is not effective.
The Liaison Committee on Resuscitation (ILCOR) recognizes a knowledge gap in optimal education techniques for first aid providers. This review aims to describe training and evaluation methods for teaching tourniquet use to both health care and military professionals.
Methods:
The MEDLINE, CINAHL, WEB of Science, and Scopus databases were reviewed (from 2010 through April 2020). The quality of the selected studies was assessed using the Consolidated Standards of Reporting Trials (CONSORT) scale. Studies that met at least 65% of the included items were included. Data were extracted independently by two reviewers.
Results:
Ten of the 172 articles found were selected, of which three were randomized clinical trials. Heterogeneity was observed in the design of the studies and in the training and evaluative methods that limit the comparison between studies.
Conclusions:
The results suggest that the training strategies studied are effective in improving knowledge, attitudes, and practical skills. There is no universal method, learning is meaningful but research should be directed to find out which ones work best.
The justice literature has coalesced around the notion that actors (e.g., supervisors) tend to utilize the norm of equity for resource allocation decisions because it is generally considered most fair when employees who contribute more to the organization receive more resources. Yet, actors might sometimes utilize a need norm to allocate resources to those most in need. Studies that have addressed need-based resource allocations have assumed a relatively straightforward conceptualization of need. However, research from related areas suggests that multiple characteristics of the need itself could trigger actors’ use of a need norm to allocate resources. We advance a theoretical framework that outlines various need characteristics that drive actors’ use of a need norm. The framework draws on the processes outlined in attribution theory and integrates those with the content domains addressed in fairness theory. A discussion of the implications for justice, attribution, and fairness theory research follows.
Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2–positive and –negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.
Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.
Methods:
International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.
Results:
In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).
The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.
Conclusions:
Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.
Community engagement (CE) is critical for research on the adoption and use of assistive technology (AT) in many populations living in resource-limited environments. Few studies have described the process that was used for engaging communities in AT research, particularly within low-income communities of older Hispanic with disabilities where limited access, culture, and mistrust must be navigated. We aimed to identify effective practices to enhance CE of low-income Hispanic communities in AT research.
Methods:
The community stakeholders included community-based organizations, the community healthcare clinic, the local AT project, and residents of the Caño Martín Peña Community in San Juan, Puerto Rico. The CE procedures and activities during the Planning the Study Phase comprised working group meetings with stakeholders to cocreate the funding proposal for the study and address the reviewers’ critiques. During the Conducting the Study Phase, we convened a Community Advisory Board to assist in the implementation of the study. During the Disseminating the Study Results Phase, we developed and implemented plans to disseminate the research results.
Results:
We identified seven distinct practices to enhance CE in AT research with Hispanic communities: (1) early and continuous input; (2) building trusting and warm relationships through personal connections; (3) establishing and maintaining presence in the community; (4) power sharing; (5) shared language; (6) ongoing mentorship and support to community members; and (7) adapting to the changing needs of the community.
Conclusion:
Greater attention to CE practices may improve the effectiveness and sustainability of AT research with low-income communities.
Worldwide obesity is increasing at an alarming rate in children and adolescents, with the consequent emergence of co-morbidities. Moreover, the maternal environment during pregnancy plays an important role in obesity, contributing to transgenerational transmission of the same and metabolic dysfunction. White adipose tissue represents a prime target of metabolic programming induced by maternal milieu. In this article, we review adipose tissue physiology and development, as well as maternal influences during the perinatal period that may lead to obesity in early postnatal life and adulthood. First, we describe the adipose tissue cell composition, distribution and hormonal action, together with the evidence of hormonal factors participating in fetal/postnatal programming. Subsequently, we describe the critical periods of adipose tissue development and the relationship of gestational and early postnatal life with healthy fetal adipose tissue expansion. Furthermore, we discuss the evidence showing that adipose tissue is an important target for nutritional, hormonal and epigenetic signals to modulate fetal growth. Finally, we describe nutritional, hormonal, epigenetic and microbiome changes observed in maternal obesity, and whether their disruption alters fetal growth and adiposity. The presented evidence supports the developmental origins of health and disease concept, which proposes that the homeostatic system is affected during gestational and postnatal development, impeding the ability to regulate body weight after birth, thereby resulting in adult obesity. Consequently, we anticipate that promoting a healthy early-life programming of adipose tissue and increasing the knowledge of the mechanisms by which maternal factors affect the health of future generations may offer novel strategies for explaining and addressing worldwide health problems such as obesity.