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Objective: This study aims to describe clinical variables and quality care indicators in pediatric stroke management at a high-complexity pediatric care center in Latin America., Methods: Retrospective study of patients with stroke, aged 2-18 years from 2011 to 2021. The principal outcomes were the mRs and mortality. Differences between groups were assessed using Fisher's exact test and the Mann-Whitney U test. We used logistic regression to explore the association between characteristics reported as relevant in literature and mortality., Results: One hundred thirty six patients included, with a median age of 11 years, 54% were male. 47% were hemorrhagic strokes, followed by ischemic strokes at 39%. One-third of the cases presented in hospital. 51% of the patients had no prior medical history. The most common symptoms were altered consciousness, headache, and hemiparesis. The median door-to-image time was 123 min. The most frequent etiologies in ischemic stroke were arteriopathies and cardiac pathology, while vascular malformation and coagulopathies were predominant in hemorrhagic stroke. No patient received reperfusion therapy. At discharge, 48% of patients had a favorable mRs. The mortality rate was 21%. Patients with in-hospital stroke have approximately 7.37 times the odds of dying compared to those with out-of-hospital stroke. Patients with hemorrhagic stroke have approximately 7.46 times the odds of dying compared to those with ischemic stroke., Conclusion: Significant gaps exist in the epidemiology and quality indicators of pediatric stroke care compared to adult protocols. Implementing a "Pediatric code stroke" protocol and conducting prospective studies are crucial for improving pediatric stroke care and outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Valencia-Cifuentes, Llanos-Leyton, Gómez-Ayala, Ariza-Insignares, Rivillas, Granados-Sánchez, Márquez, Galvis-Blanco, Cruz-Zamorano, Gómez-Castro, Rámirez-Muñoz, Castro-Varela, Lasso, Benavides-Llano and Amaya.)

Agricultural systems tend to be characterised by large diversity, therefore, solving socio-economic and environmental problems in agriculture requires targeted and contextualised policies. However, policies often fail to recognize this heterogeneity in their design or implementation. This can result in the use of sector-wide characteristics and, consequently, generic policies that are not tailored to specific farming systems. In this context, farm typologies can be a useful tool, as they help to identify differences and commonalities in highly heterogeneous groups. In this study, we focused on the Irish beef and sheep farming sectors and used a wide range of structural, socio-economic, and environmental indicators to develop a farm typology. This resulted in the identification of six distinct farm types: Small Cattle Farms, Extensive Sheep Farms, Medium-size Sheep Farms, Medium-size Cattle Farms, Medium-size Mixed Farms, and Intensive Cattle Farms. We then analysed the socio-economic and environmental performance of these six farm types and discussed the potential variation of the implementation and impact of currently proposed policies and interventions among farm types. We argue that failing to consider different farm types within policies can make their farm-level implementation unsuccessful and thus hinder the achievement of sector-wide sustainability goals. The approach we developed in this manuscript could also be applicable to other sectors and locations, and could help guide the design of more successful targeted policies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relation-ships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Scholarly research has consistently shown that teachers present negative assessments of and attitudes toward migrant students. However, previous studies have not clearly addressed the distinction between implicit and explicit prejudices, or identified their underlying sources. This study identifies the explicit and implicit prejudices held by elementary and middle school teachers regarding the learning abilities of an ethnic minority group: Haitian students within the Chilean educational system. We use a list experiment to assess how social desirability and intergroup attitudes toward minority students influence teachers' prejudices. The findings reveal that teachers harbor implicit prejudices towards Haitian students and are truthful in reporting their attitudes, thereby contradicting the desirability bias hypothesis. We suggest that teachers rely on stereotypes associated with the students' nationality when assessing Haitian students' learning abilities. The implications of these results are discussed in relation to theories grounded in stereotypes and intergroup attitudes., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: After acute phase of SARS-CoV-2 infection, some patients persist with clinical symptoms, a phenomenon known as Long COVID syndrome. It is necessary to understand the factors associated with the persistence of these symptoms to develop individualized preventive approaches and effectively address this challenge., Objective: To determine the factors associated with the persistence of symptoms six months after COVID-19 infection., Materials and Methods: A ambidirectional cohort, single-center study, that included individuals previously diagnosed with COVID-19 by real-time polymerase chain reaction (PCR) positive test, who were followed for a period of six months. Univariate, bivariate and a multivariate binomial regression model were performed to determine risk factors associated with the persistence of COVID-19 symptoms at the six months of follow-up., Results: The prevalence of long COVID syndrome was 47%. Age demonstrated no significant association with Long COVID (RR 0.999 [95% CI 0.996-1.002]); however, female sex (RR 1.148 [95% CI 1.038-1.268]), requirement of mechanical ventilation (RR 1.278 [95% CI 1.050-1.555]), presence of Chronic Obstructive Pulmonary Disease (COPD) (RR 1.340 [95% CI 1.104-1.626]), Rheumatic Disease (RR 1.259 [95% CI 1.055-1.504]) and the Hospitalization Type: General Hospitalization (RR 1.247 [95% CI 1.090-1.427]) and ICU Hospitalization (RR 1.490 [95% CI 1.221-1.818]) were significantly associated with the persistence of symptoms at the six month of follow-up., Conclusion: Female sex, presence of COPD, rheumatic disease, hospitalization type and requirement of mechanical ventilation during index infection were identified as significant risk factors for the diagnosis of Long COVID. These findings emphasize the importance of addressing Long COVID syndrome in terms of prevention and management, taking these risk factors into consideration., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Martínez-Ayala, Proaños, Cala-Duran, Lora-Mantilla, Cáceres-Ramírez, Villabona-Flórez and Camacho-López.)

The present study examined how the dosage and quality of the federal preschool program "Head Start" (HS) in the US related to children's self-regulation skills in kindergarten. Using Propensity Score Matching and multiple regression (OLS), this study explored how the number of years and hours a week of HS were related to self-regulation among 2,383 children, who entered the program either at 3 or 4 years old. An additional year in HS was significantly positively associated with self-regulation in kindergarten, while the number of hours a week in HS was not. However, the quality of teacher-child interactions moderated the relation between hours a week in HS and self-regulation. Findings contribute to the growing body of evidence about how dosage and quality of early childhood education experiences relate to children's development., (© The Author(s), under exclusive licence to Springer Nature B.V. 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: This systematic review summarises the existing evidence on the implementation of technology-based mental healthcare models in the primary care setting., Methods: A systematic search was conducted (MEDLINE, Embase, CENTRAL) in August 2019 and studies were selected according to predefined eligibility criteria. The main outcomes were clinical effectiveness, adherence to primary treatment and cost of implementation., Selection Criteria: Studies with an experimental or quasi-experimental design that evaluated the implementation of technology-based mental healthcare models were included., Results: Five articles met the inclusion criteria. The models included technological devices such as tablets, cellphones and computers, with programs and mobile apps that supported decision-making in the care pathway. These decisions took place at different times, from the universal screening phase to the follow-up of patients with specific conditions. In general, the studies showed a decrease in the reported symptoms. However, there was great heterogeneity in both the health conditions and the outcomes, which hindered a quantitative synthesis. The assessment of risk of bias showed low quality of evidence., Conclusion: There is not enough evidence to support the implementation of a technology-based mental healthcare model. High quality studies that focus on implementation and effectiveness outcomes are needed to evaluate the impact of technology-based mental healthcare models in the primary care setting., (Copyright © 2021. Published by Elsevier España, S.L.U.)

The DIADA project, understood as a mental healthcare implementation experience in the context of a middle-income country like Colombia, promotes a necessary discussion about its role in the global mental health framework. The following article outlines the main points by which this relationship occurs, understanding how the project contributes to global mental health and, at the same time, how global mental health nurtures the development of this project. It reflects on aspects like the systematic screening of patients with mental illness, the use of technology in health, the adoption of a collaborative model, the investigation on implementation, a collaborative learning and the Colombian healthcare system. These are all key aspects when interpreting the feedback cycle between the individual and the global. The analysis of these components shows how collaborative learning is a central axis in the growth of global mental health: from the incorporation of methodologies, implementation of models, assessment of outcomes and, finally, the dissemination of results to local, regional and international stakeholders., (Copyright © 2021 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Possible COVID-19 pneumonia patients (ppCOVID-19) generally overwhelmed emergency departments (EDs) during the first COVID-19 wave. Home-confinement and primary-care phone follow-up was the first-level regional policy for preventing EDs to collapse. But when X-rays were needed, the traditional outpatient workflow at the radiology department was inefficient and potential interpersonal infections were of concern. We aimed to assess the efficiency of a primary-care high-resolution radiology service (pcHRRS) for ppCOVID-19 in terms of time at hospital and decision's reliability., Methods: We assessed 849 consecutive ppCOVID-19 patients, 418 through the pcHRRS (home-confined ppCOVID-19 with negative-group 1- and positive-group 2-X-rays) and 431 arriving with respiratory symptoms to the ED by themselves (group 3). The pcHRRS provided X-rays and oximetry in an only-one-patient agenda. Radiologists made next-step decisions (group 1: pneumonia negative, home-confinement follow-up; group 2: pneumonia positive, ED assessment) according to X-ray results. We used ANOVA and Bonferroni correction, Student T, Chi 2 tests to analyse changes in the ED workload, time-to-decision differences between groups, potential delays in patients acceding through the ED, and pcHRRS performance for deciding admission., Results: The pcHRRS halved ED respiratory patients (49.2%), allowed faster decisions (group 1 vs. home-discharged group 2 and group 3 patients: 0:41 ± 1:05 h; 3:36 ± 2:58 h; 3:50 ± 3:16 h; group 1 vs. all group 2 and group 3 patients: 0:41 ± 1:05 h; 5.25 ± 3.08; 5:36 ± 4:36 h; group 2 vs. group 3 admitted patients: 5:27 ± 3:08 h vs. 7:42 ± 5:02 h; all p < 0.001) and prompted admission (84/93, 90.3%) while maintaining time response for ED patients., Conclusions: Our pcHRRS may be a more efficient entry-door for ppCOVID-19 by decreasing ED patients and making expedited decisions while guaranteeing social distance.

Background: Dialyzable leukocyte extracts (DLE) have been used to treat several cellular immunodeficiency., Objective: To review the experience of a tertiary hospital in the use of DLE for the treatment of recurrent or severe infections in children with acquired cellular immunodeficiency not due to HIV., Methods: We reviewed the medical records of all children who received treatment with EDL of human or bovine origin between 1986 and 2000 to detect recurrent or severe infections without response to a specific antimicrobial therapy and with a quantitative or qualitative deficit in the cellular immune response. The dose of DLE was adjusted according to the percentage of T lymphocytes; the evolution of the patient was evaluated retrospectively for 5 years, the immune response was evaluated by subpopulation of lymphocytes and intradermal tests and inhibition of the leukocyte migration assay (LIF) to PPD, coccidioidin, varidase and candidin., Results: 150 children received DLE, age 7.0 ± 5.9 years. The most frequent indications included upper respiratory tract (71%), lower respiratory tract (43%), gastrointestinal tract (15%), urinary tract (15%) and neurological infections (4%) and coccidioidomycosis (3%). After starting the DLE, the numbers of T lymphocytes, LIF to PPD and varidase (> 20%) and the intradermal induration of the test increased (p <0.001). In 6 patients (4%) recurrences of respiratory and gastrointestinal tract infections were observed, which resolved, no adverse effects attributable to the DLE were reported., Conclusions: The use of DLE for recurrent or severe infectious processes in children with cellular immune deficit improved the clinical evolution and the immunological parameters evaluated without adverse effects attributable to their use.

Incidence of Behçet disease in USA is 0.12 in 100,000; but in Mexico there are just two isolated cases. This paper reports a case of a 30 year-old female, who, when 26, had vaginal ulcers. She received antimicrobial therapy during four years. In March 2007 she came to author's hospital with a cervical vaginitis diagnose study, and presenting thorax with venous collateral circulation secondary to superior and inferior cava vein thrombosis. Colposcopy and vaginal wall biopsy were practiced and found chronic ulcer with vascular damage; oral ulcers were found too, and Pathergy test was positive. Currently there is no ocular damage. Patient received azathioprine therapy without improvement, later she received anticoagulant therapy with corticoids and has good evolution.