Resumen Introducción: El avance en los tratamientos oncológicos, como la inmunoterapia, conlleva una mayor complejidad de la asistencia y del cuidado hacia el paciente. Metodología: Estudio descriptivo en el que participaron 100 sujetos tenía como objetivo principal describir los principales efectos inmunomediados en los pacientes atendidos en la consulta de enfermería. Resultados: El cáncer de pulmón es la enfermedad oncológica donde más se prescribe inmunoterapia, siendo los principales efectos inmunomediados: astenia, artralgia y mialgias, seguido de hepatitis en grado 2-3. Discusión: el efecto inmunomediado de afectación hepática no coincide con lo hallado en otros estudios.

Abstract Introduction: There has been a great advance in treatments in oncology, the adverse effects of immunotherapy entails a greater complexity of care. Methodology: Descriptive study on the main immune-mediated effects detected in the newly created nursing consultation This study has an intensification grant from the research institute of the hospital of realization. Results: N=100 patients where the main immune-mediated effects have been asthenia, arthralgia and myalgia, followed by grade 2-3 transaminitis. Discussion: The main effect has been hepatitis, which does not coincide with other studies.

Summary: In the immediate future and the medium term, activities of Scientific and Technological Research, Human Resource Training, and Linkage and Social Appropriation of Knowledge will suffer the hardships of the new restrictions imposed by the new reality of the COVID-19 Pandemic. Societies, economies, Research and Higher Education Institutions that manage to adapt faster to these new challenges and have the structural capacities to make their processes flexible, will have a better chance to fastly overcome this global contingency. In Mexico, un-der the perspective of social transfer of knowledge, far from being a disruptive phenomenon, the evolution that this transfer has followed seems to find -from the confinement and impact of the COVID 19 pandemic- real possibilities of increasing interest for science topics and the opportunity of accessing them through the use of information technologies (ICTs). This is the case of actions for the social transfer of knowledge in a public research center, Centro de Investigaciones Biológicas del Noroeste, S.C. (CIBNOR), in which digital platforms have been consolidated to positively face the times. In this work, detailed, concrete and specific recom-mendations are provided so that the public institutions of research and Higher Education in Mexico can adapt to the new reality imposed by the pandemic as efficiently and functionally as possible in terms of scientific, humanistic and technological research, the training of human resources, and in the linkage and social appropriation of knowledge.

Resumen: En el futuro inmediato y a mediano plazo las actividades de Investigación Científica y Tecnológica, Formación de Recursos Humanos, Vinculación y Apropiación Social del Conocimiento padecerán los embates de las nuevas restricciones que ha impuesto la nueva realidad de la Pandemia por COVID-19. Las sociedades, economías, Instituciones de Investigación y de Educación Superior que logren adaptarse más rápido a estos nuevos retos y posean las capacidades estructurales para hacer flexibles sus procesos, tendrán posibilidades de salir más rápido de esta contingencia global. En México, desde el punto de vista de la transferencia social del conocimiento, lejos de ser un fenómeno disruptivo, la evolución que ha seguido esta transferencia pareciera encontrar desde el confinamiento y el impacto de la pandemia COVID-9, posibilidades reales de incrementar el interés por los temas de ciencia y la posibilidad de acceder a ellos mediante el uso de las tecnologías de la información (TIC´s). Este es el caso de las acciones de transferencia social del conocimiento en un centro público de investigación como el Centro de Investigaciones Biológicas del Noroeste, S.C. (CIBNOR), en el que se han consolidado las plataformas digitales para enfrentar de manera positiva los tiempos. En este trabajo se ofrecen recomendaciones detalladas, concretas y específicas para que las instituciones públicas de investigación y de Educación Superior en México se adapten lo más eficiente y ejecutivamente, en materia de investigación científica, humanística y tecnológica, formación de recursos humanos, vinculación y apropiación social del conocimiento a la nueva realidad impuesta por la pandemia.

Introdução: Alterações psicopatológicas são comuns durante a gravidez e a sua deteção e referenciação a cuidados especializados é frequentemente deficitária. O objetivo deste estudo foi efetuar uma análise descritiva de dados sociodemográficos, de saúde mental e obstétricos de uma amostra de grávidas em seguimento em consulta de Psiquiatria. Material e Métodos: Este foi um estudo transversal e descritivo. A amostra foi selecionada por cruzamento dos processos de doentes com seguimento em consulta de Ginecologia/Obstetrícia e Psiquiatria no Hospital Prof. Doutor Fernando Fonseca entre 2014 e 2016. Foram obtidos 76 processos, tendo sido colhidas e analisadas variáveis previamente identificadas na literatura como estando associadas a risco de desenvolvimento de alterações psicopatológicas durante a gravidez. Resultados e Discussão: Foram identificados fatores de risco para o desenvolvimento de sintomas depressivos, nomeadamente ausência de relacionamento afetivo durante a gestação (n=11; 14,5%), ser imigrante de 1ª geração (n=17; 22,4%) e consumos toxicofílicos antes (n=18; 23,7%) ou durante (n=10; 13,1%) a gravidez. A amostra foi dividida entre mulheres com acompanhamento pregresso em Psiquiatria que engravidaram (n=44; 57,9%) e mulheres referenciadas para consulta de Psiquiatria durante a gestação (n=32; 42,1%). Neste segundo grupo, 18,8% (n=6) das referenciações foram feitas a partir dos cuidados de saúde primários, sendo importante perceber se tal se trata de uma sub-referenciação. Foram prescritos 21 fármacos da categoria de risco D, o que alerta para a necessidade de precaução na prescrição farmacológica e de considerar alternativas não farmacológicas (e.g. terapia cognitivo-comportamental) na orientação destes casos. Conclusões: Este estudo permitiu identificar fatores de risco para psicopatologia, representando uma oportunidade de otimizar a prática clínica e o seguimento destas doentes.

Introduction: Psychopathological symptoms are common during pregnancy and their detection and referral to specialized care is often suboptimal. The aim of this study was to perform a descriptive analysis of sociodemographic, mental health, and obstetric features of a population of pregnant women followed at Psychiatry consultation. Methodology: This was a cross-sectional, descriptive study of women followed both at Gynecology/Obstetrics and Psychiatry consultations of Hospital Prof. Doutor Fernando Fonseca between 2014 and 2016. A total of 76 women were included, for whom pre-defined features associated in the literature with risk of developing psychopathological symptoms during pregnancy were collected. Results and Discussion: Risk factors identified in the development of depressive symptoms included absence of an affective relationship during pregnancy (n=11; 14.5%), being first-generation immigrant (n=17; 22.4%), and substance use before (n=18; 23.7%) or during (n=10; 13.1%) pregnancy. Sample was divided into women with previous Psychiatry follow-up who became pregnant (n=44; 57.9%) and women referred to Psychiatry consultation during pregnancy (n=32; 42.1%). In the second group, 18.8% (n=6) of referrals were from primary health care, being relevant to understand whether this represents an under-referral. Prescription of 21 risk category D drugs was identified, alerting to the need of caution in pharmacological prescription and of considering non-pharmacological options (e.g., cognitive-behavioral therapy) for management of these cases. Conclusions: Risk factors identified in this study represent an opportunity to optimize clinical practice and improve these patients’ follow-up.

Abstract The Cape Region (CR) of Baja California Sur is located in the southernmost tip of the Baja California peninsula, Mexico. The vegetation of this region is dominated by scrubland (SRB) and tropical dry forest (TDF), but oak (OW) and oak-pine woodland (OWP) are also found in Sierra La Laguna Biosphere Reserve. These vegetation types, in this relatively small area, make the CR a contrasting and highly biodiverse region. This research used the Normalised Difference Vegetation Index (NDVI) to describe spatiotemporal variability of the vegetation cover in the CR. The analysed NDVI data derived from Landsat 7 during the growing season (September-November) from 2001-2015. Its spatial distribution showed the highest values in the TDF, OW and OPW. Higher variability was observed in SRB. Temporal variations of the annual NDVI mean of the growing season fluctuated in a range from 0.292 to 0.522, and with the highest values in 2014 while the lowest were observed in 2011. A general increasing trend was observed for the growing season over the period 2001-2015 for all analysed vegetation types. Remote sensing change detection methods combined with Geographic Information Systems, suggested that the vegetation of the area was well conserved during the period of study.

Resumen La región del cabo (CR) de Baja California Sur se encuentra en el extremo sur de la península de Baja California, México. La vegetación de esta región está dominada por matorrales (SRB) y bosques secos tropicales (TDF), pero los bosques de encino (OW) y encino-pino (OWP) también se encuentran en la Reserva de la Biosfera Sierra La Laguna. Estos tipos de vegetación, en esta área relativamente pequeña, hacen de la CR una región contrastante y altamente biodiversa. Esta investigación utilizó el índice de vegetación de diferencia normalizada (NDVI) para describir la variabilidad espacio-temporal de la cubierta vegetal en la CR. Los datos analizados del NDVI se derivaron del Landsat 7 durante la temporada de crecimiento (septiembre-noviembre) de 2001 a 2015. Su distribución espacial mostró los valores más altos en TDF, OW y OPW. Se observó una mayor variabilidad en SRB. Las variaciones temporales de la media anual de NDVI de la temporada de crecimiento fluctuaron de 0.292 a 0.522, con los valores más altos en 2014, mientras que los más bajos se observaron en 2011. Se observó una tendencia general creciente para la temporada de crecimiento durante el período 2001-2015 para todos los tipos de vegetación analizados. Los métodos de detección de cambios por detección remota combinados con los sistemas de información geográfica, sugirieron que la vegetación del área estaba bien conservada durante el período de estudio.

ABSTRACT Background It has been proposed that Vitamin D helps reduce the accumulation of cerebral β-amyloid-42 by innate immune stimulation and phagocytosis activation. An association between low Vitamin D levels and Alzheimer’s dementia (AD) has been established. We determined the association between Vitamin D, mild cognitive impairment (MCI), and AD in older Mexican adults (> 65 years) Methods Cross-sectional study conducted at the memory clinic in a tertiary-level hospital in Mexico City. We evaluated subjects with MCI, AD, and normal cognition (NC) with available serum Vitamin D [25(OH)D] levels (past 6 months). Three categories were assigned according to 25(OH)D levels: sufficiency (> 30 ng/mL), insufficiency (21-29 ng/mL), and deficiency (≤ 20 ng/mL). Descriptive statistics, means and standard deviations were used. Logistic regression analyses adjusted by age, sex, and educational level were performed Results We evaluated 208 patients. Mean age was 79 ± 1 year, 65% (n = 136) were female; and mean educational level was 6.7 ± 2.3 years. Thirty-one subjects (14%) had NC; 42% (n = 88) had MCI; and 43% (n = 89) had AD. Prevalence of Vitamin D deficiency was 54%, more frequent in the AD group (64%) followed by the MCI (59%) and NC (13%) (p < 0.001) groups. In the multivariate logistic regression analysis, Vitamin D deficiency was associated with MCI (HR 25.02 [confidence interval 95% 4.48-139]; p < 0.001) and AD (HR 41.7 [5.76-301]; p < 0.001) after adjusting for confounders Conclusions Serum Vitamin D deficiency was associated with MCI and dementia; low levels produced a greater effect over executive functions.

A perturbação dismórfica corporal (PDC) é uma doença incapacitante de elevada prevalência, que se manifesta através de uma preocupação excessiva com um ou mais defeitos corporais percebidos. A investigação até à data aponta a terapia cognitivo-comportamental (TCC) como um tratamento eficaz nesta patologia. O objetivo deste trabalho consistiu em fornecer uma revisão estruturada sobre o papel da TCC na PDC, abordando os modelos cognitivo-comportamentais e a sua eficácia. Assim, foi levada a cabo uma revisão não sistematizada da literatura através de uma pesquisa bibliográfica no PubMed. Aferiu-se que vários estudos têm escrutinado os fatores influentes na etiologia e manutenção da PDC, permitindo desenvolver modelos cognitivo-comportamentais explicativos do padrão de sintomas da doença. Tais modelos sugerem que estes doentes focam seletivamente a atenção nos defeitos percebidos e apresentam esquemas cognitivos disfuncionais sobre si e sobre os outros. Estes esquemas resultam em avaliações incorretas de estímulos sociais ambíguos, que são encarados como negativos, despoletando emoções negativas. Para reduzir estas emoções, os doentes recorrem a comportamentos de segurança e/ou evitamento que, funcionando como reforço negativo, perpetuam as crenças disfuncionais. As principais componentes da TCC para a PDC são a psicoeducação, a intervenção motivacional, a reestruturação cognitiva, a exposição com prevenção de resposta, o perceptual mirror retraining e a prevenção de recaída. Até à data, os estudos realizados evidenciam bons resultados da TCC na PDC. Contudo, verifica-se um elevado número de doentes que mantém sintomatologia significativa. Assim, apesar da TCC parecer eficaz no tratamento da PDC, continua a ser necessário realizar investigação adicional.

Body dysmorphic disorder (BDD) is an incapacitating disease of high prevalence, which manifests itself through excessive concerns with one or more physical perceived defects. Up to date research has found cognitive-behavioral therapy (CBT) as an effective treatment for this disease. The objective of this work was to provide a structured review of the role of CBT in BDD, addressing cognitive-behavioral models and their effectiveness. Thus, a non-systematized review of the literature was carried out through a bibliographic research at PubMed. Results show that several studies have examined the factors influencing the aetiology and maintenance of BDD, allowing the development of cognitive-behavioral explanatory models about the disease’s symptoms. These models suggest that these patients selectively focus their attention on the perceived flaws and present dysfunctional cognitive schema about themselves and others. These schema result in incorrect evaluations of ambiguous social stimuli, which are interpreted as negative, leading to negative emotions. In order to reduce these emotions, they go through safety and/or avoidance behaviors that, working as negative reinforcements, perpetuate dysfunctional beliefs. The main components of CBT for BDD are psychoeducation, motivational enhancement strategies, cognitive restructuring, exposure with response prevention, perceptual mirror retraining and relapse prevention. The studies carried until now show good results of CBT for BDD. However, there is a high number of patients who still maintain significant symptomatology. Thus, despite CBT seeming effective in the treatment of BDD, it is still necessary to carry out additional research.

A Perturbação de Acumulação (PA), ou, em terminologia anglo-saxónica, Hoarding Disorder, é uma entidade clínica com início insidioso, curso crónico e de agravamento progressivo, caracterizada por excessiva aquisição e recusa no descarte de objetos, com consequente acumulação destes habitualmente em espaços residenciais. Esta característica da PA é geradora de múltiplos perigos com impacto na morbilidade e mortalidade física. A etiologia é multifatorial consistindo em défices cognitivos, crenças mal-adaptativas, como o perfeccionismo e o medo de tomar decisões erradas, e padrões comportamentais disfuncionais também associados a co-morbilidades psiquiátricas. O funcionamento individual, familiar e social é severamente prejudicado. Dado a cronicidade desta patologia, o objetivo do tratamento é a melhoria da sintomatologia e não a sua remissão total. A psicoterapia cognitivo-comportamental (TCC) adaptada à PA é a forma mais estudada para o tratamento dos indivíduos com acumulação compulsiva. A ineficácia do tratamento farmacológico levou ao desenvolvimento de intervenções cognitivo-comportamentais específicas e adaptadas às dificuldades dos indivíduos com esta patologia.

Hoarding disorder is a clinical entity with insidious onset, chronic course and endless aggravation, characterized by excessive acquisition and refuse to discard objects, with consequent accumulation, habitually at residential spaces. This disorder’s features generates multiple dangers with impact on physical morbidity and with mortality risk. The etiology is multifactorial consisting of cognitive deficits, maladaptive beliefs, such as perfectionism and the fear of making wrong decisions, and dysfunctional behavioral patterns also associated a psychiatric comorbidities. Individual, family and social functioning are severely impaired. Given the chronicity of this pathology, the objective of the treatment is the improvement of the symptomatology and not its total remission. Cognitive-behavioral therapy adapted to hoarding disorder is the most studied form for the treatment of individuals with compulsive accumulation. The ineffectiveness of pharmacological treatment led to the development of specific cognitive-behavioral interventions adapted to the difficulties of individuals with this pathology.

ABSTRACT Objective: to discuss the findings of publications addressing the repercussions of difficult news given to clients by nurses working in cancer care. Method: integrative literature review analyzing publications addressing the repercussions of difficult news given to clients by nurses working in cancer care indexed in databases from 2011 to 2015. The search was performed from May to September 2015 in the LILACS, MEDLINE and BDENF databases. Of the 182 articles found, 156 which did not meet the criteria established were excluded. The final sample consisted of 26 articles. Results: analysis and synthesis of the recorded data obtained the categories: Difficulties in giving difficult news; Developing skills in giving difficult news; Professional training; and Nurse-client relations. Conclusion: there is a need for health personnel to develop social skills for giving news of difficult situations in the course of cancer diseases.

RESUMEN Objetivo: discutir los hallazgos de publicaciones que tratan sobre las repercusiones de comunicación de malas noticias a los clientes por parte de enfermeros que trabajan en atención oncológica. Método: una revisión integrativa de literatura que analiza las publicaciones indexadas en bases de datos, en el período comprendido entre 2011 a 2015, abordando el impacto de la comunicación de malas noticias a los clientes por parte de enfermeros que trabajan en la atención oncológica. La búsqueda se realizó en el período comprendido entre mayo y septiembre de 2015 en las bases LILACS, MEDLINE y BDENF. Se han encontrado 182 artículos, 156 fueron excluidos puesto que no cumplían con los criterios establecidos. La muestra final estuvo compuesta por 26 artículos. Resultados: tras el análisis y síntesis de los datos registrados, se obtuvieron las categorías: dificultades en la comunicación de malas noticias; desarrollo de habilidades en la comunicación de malas noticias; Desarrollo de habilidades para hacer esas comunicaciones; Repercusiones de esas malas noticias; Formación profesional; Relación enfermero-cliente. Conclusión: existe la necesidad de desarrollar habilidades sociales por parte de profesionales de salud para la comunicación de situaciones difíciles en el curso de las enfermedades oncológicas.

RESUMO Objetivo: discutir os achados de publicações, abordando repercussões da comunicação de notícias difíceis aos clientes por enfermeiros atuantes em atenção oncológica. Método: revisão integrativa de literatura analisando publicações indexadas em bancos de dados, no período de 2011 a 2015, abordando as repercussões da comunicação de noticias difíceis aos clientes por enfermeiros atuantes na atenção oncológica. A busca foi realizada no período de maio a setembro de 2015 nas bases LILACS, MEDLINE e BDENF. Foram encontrados182 artigos, sendo excluídos 156 que não atenderam aos critérios estabelecidos. A amostra final foi composta por 26 artigos. Resultados: após a análise e síntese dos dados registrados, obteve-se as categorias: Dificuldades na comunicação de notícias difíceis; Desenvolvimento de habilidades dessas comunicações; Repercussões dessas notícias; Formação Profissional; Relação enfermeiro-cliente. Conclusão: há necessidade do desenvolvimento de habilidades sociais por parte dos profissionais de saúde para a comunicação de situações difíceis no percurso da doença oncológica.

Resumo Introdução Mulheres necessitam de contracepção até atingirem a menopausa. Os contraceptivos reversíveis de longa duração e o acetato de medroxiprogesterona de depósito (AMPD) são ótimas opções para substituir possíveis esterilizações. Objetivo Avaliar a relação entre o uso de contraceptivos reversíveis de longa duração (LARCs) e AMPD com terminações atribuídas à menopausa e a esterilizações em uma clínica brasileira. Métodos Revisamos os registros de mulheres entre 12 e 50 anos de idade atendidas em clínica e que escolheram usar LARC ou AMPD. Índices de terminação acumulada devido à esterilização ou à menopausa foram computados usando análise de tabela de vida durante 32 anos. Também examinamos todos os registros de cirurgias de esterilização em nosso hospital no período de 1980 a 2012. Resultados Trezentas e trinta e duas mulheres usaram continuamente o mesmo contraceptivo até a menopausa, e 555 mulheres não deram continuidade ao método pelo fato de elas ou seus parceiros terem se submetido à esterilização. De 20 a 30 anos de uso, usuários de sistema intrauterino de levonorgestrel, dispositivo intrauterino de cobre e AMPD apresentaram tendência de maiores índices de descontinuidade devido à menopausa quando comparados a índices de descontinuidade devido à esterilização. No período de estudo, ocorreu um declínio acentuado no uso de esterilização. Conclusão Nos últimos 15 anos do estudo, foi observada uma tendência na qual mulheres optaram mais por continuar usando LARC ou AMPD até a menopausa do que pela esterilização própria ou de seus parceiros. O número anual de esterilizações caiu no mesmo período. O uso de LARC e AMPD até a menopausa é uma opção importante para evitar a esterilização, que exige um procedimento cirúrgico com potenciais complicações.

Abstract Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera(r), Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and terminations ascribed to menopause and sterilizations in a Brazilian clinic. Methods We reviewed the records of women between 12 and 50 years of age attending the clinic that chose to use a LARC method or DMPA. Cumulative termination rates due to sterilization or because the woman had reached menopause were computed using single decrement life-table analysis over 32 years. We also examined all records of surgical sterilization at our hospital between the years 1980-2012. Results Three hundred thirty-two women had continuously used the same contraceptive until menopause, and 555 women had discontinued the method because they or their partners underwent sterilization. From year 20 to year 30 of use, levonorgestrel intrauterine-releasing system (LNG-IUS - Mirena(r), Bayer Oy, Turku, Finland; available since 1980), copper intrauterine device (IUD - available since 1980) and DMPA users showed a trend of cumulative higher discontinuation rates due to menopause when compared with the discontinuation rates due to sterilization. Over the study period, a steep decline in the use of sterilization occurred. Conclusion Over the past 15 years of research we have observed a trend: women usually preferred to continue using LARC methods or DMPA until menopause rather than decide for sterilization, be it their own, or their partners'. The annual number of sterilizations dropped in the same period. The use of LARC methods and DMPA until menopause is an important option to avoid sterilization, which requires a surgical procedure with potential complications.

Abstract: Water used by bighorn sheep during the 2011 and 2013 dry seasons and the rainy season and drought of 2015 in the Sierra Santa Isabel of the State of Baja California, Mexico was analyzed for seven physicochemical parameters. At four watering sites, 260 photographs of sheep were obtained. Females, yearlings, and lambs accounted for 73% of the photographs. In the rainy season at two watering sites, conductivity was 1.31 μS/cm2 and 1.92 μS/cm2 and total dissolved solids was 0.65 and 0.95 ppt, indicating low salt content and safe for bighorn sheep. The watering sites with greater use by bighorn sheep were El Zamora (n = 120) and El Cordero (n = 67), which also had the best water quality. The frequent use by females and yearlings of the two sites with optimal water quality support the belief that watering sites for lambing and recruitment of bighorn sheep is important.

Resumen: Se analizó la utilización de aguajes por el borrego cimarrón en la Sierra Santa Isabel, Baja California, México durante la temporada de sequía de 2011 y 2013 y el periodo de lluvias e inicio de la temporada de sequía del 2015. Asimismo, se estudió la calidad del agua, con base en siete parámetros fisicoquímicos. Se obtuvieron 260 registros fotográficos de borregos cimarrones, donde hembras, añeros y corderos representaron el 73%. En el periodo de lluvias, en dos de los aguajes se obtuvieron valores de conductividad de 1.31 μS/cm2 y 1.92 μS/cm2, y de sólidos disueltos totales de l0.65 ppt y 0.95 ppt, indicando un bajo contenido de sales en el agua. Los valores de oxígeno disuelto mayores a 6.4 ppm, dureza del agua menor a 100 ppm y PH entre 6.5 y 8.5, sugieren que el agua tiene condiciones óptimas para ser bebida por los borregos cimarrones. Los aguajes con mayor utilización por los borregos fueron El Zamora (n = 120) y El Cordero (n = 67), donde se registraron las mejores condiciones de calidad de agua en este estudio. El mayor registro de hembras y añeros, asociado a condiciones óptimas de calidad del agua, confirman la importancia de los aguajes para la crianza y reclutamiento del borrego cimarrón.

Abstract: INTRODUCTION: Escape terrain and vegetation cover are two vital components in bighorn sheep habitat use. Understanding these components is essential for conserving and managing this species. Despite the importance of assessing habitat use, there are few studies in Mexico and most efforts have focused on population surveys. The lack of studies of bighorn sheep habitat in Baja California does not allow predicting possible effects of climate change, for example, reduction in availability of forage and less rainfall and increasing local extinctions of sheep populations in desert areas. Our objectives were to assess availability of escape terrain in topographic areas of varying ruggedness (flat, low hills, canyons, and steep mountains) and availability of plant cover, using an index of normalized difference in vegetation within the Sierra Santa Isabel. Additionally, selection of topographic ruggedness and vegetation cover by bighorn sheep was analyzed. The results of this study will serve to identify sites for conservation and management of Ovis canadensis and their habitat in the Baja California Peninsula. METHODOLOGY: From July 2011 through February 2012, we observed free-ranging herds of desert bighorn sheep in three time frames in two representative locations in the Santa Isabel mountains. We used terrain roughness and vegetation index, derived from Landsat images to determine the available escape terrain and vegetation cover. From the frequency of sightings and availability of habitat variables, habitat selection was analyzed, using a Chi-squared test and constructing Bonferroni confidence intervals. RESULTS: The sites with greater availability of escape terrain were more frequently selected by herds of ewes and yearlings (χ² = 9.83, P < 0.05), while herds of mixed adults selected sites having less escape terrain. During the dry season, sheep selected sites had low vegetation cover (χ² = 11.58, P < 0.05). During the rainy season, sheep selected greater vegetation cover at only one of the study sites (χ² = 8.72, P < 0.05). During the post-rainfall season, we found no relationship between vegetation cover and presence of sheep. DISCUSSION AND CONCLUSIONS: Selection of escape terrain and vegetation cover seems to be related to the sheep's anti-predatory strategy. More females (n = 140) and yearlings (n = 62) occurred where continuous habitat and permanent water was available, which confirms the importance of the Sierra Santa Isabel for breeding and recruitment of bighorn sheep in the Baja California Peninsula. The vegetation index derived from satellite imagery measured only the phenological stage of the plant community, but did not indicate which plant species are present and used by the sheep. However, the index facilitates locating areas with high availability of food and defining sampling areas to monitor populations and carry out censuses.

Resumen: INTRODUCCIÓN: El terreno de escape y la cobertura vegetal son dos componentes vitales en el hábitat del borrego cimarrón. La evaluación de la selección que hacen los borregos cimarrones de estos componentes es fundamental para determinar su distribución y el número de organismos que puede soportar un área. A pesar de la importancia de evaluar la selección del hábitat, son pocos los estudios realizados en México sobre el tema. La mayoría de las iniciativas se han enfocado en monitoreos poblacionales. La carencia de estudios sobre el hábitat del borrego cimarrón en Baja California no permite pronosticar los posibles efectos del cambio climático (e. g. una reducción en la disponibilidad de alimento como consecuencia de periodos largos sin lluvias ha ocasionado que varias poblaciones de borregos en el desierto se extirpen). Los objetivos de este estudio fueron determinar la disponibilidad del terreno de escape en diferentes categorías de rugosidad del terreno (plano, sierras bajas, cañones y sierras altas). Asimismo, mediante un índice de vegetación, se determinó la disponibilidad de la cobertura vegetal. Se analizó la preferencia de uso y la selección que hace el borrego cimarrón de las variables del hábitat. Se espera que los resultados de este estudio sirvan para la identificación de sitios a fin de manejar y conservar el Ovis canadensis y su hábitat en Sierra Santa Isabel, Baja California. METODOLOGÍA: Mediante recorridos terrestres efectuados en diferentes estaciones del año (de julio de 2011 a febrero de 2012), se realizaron observaciones directas de borregos cimarrones en dos localidades representativas de la Sierra Santa Isabel. A partir de un modelo de rugosidad del terreno y valores del índice de vegetación derivados de imágenes de satélite Landsat, se determinó el terreno de escape y la cobertura vegetal disponibles. Con la información de uso (frecuencia de observaciones de borregos cimarrones) y la disponibilidad de las variables de hábitat consideradas, se exploró la hipótesis de selección de hábitat, mediante pruebas de Chi Cuadrada y construcción de intervalos de confianza de Bonferroni. RESULTADOS: Los sitios con mayor disponibilidad de terreno de escape fueron seleccionados principalmente por grupos de hembras y añeros (χ² = 9.83, P < 0.05), mientras que grupos de adultos de ambos sexos seleccionaron sitios con una menor disponibilidad. En el periodo de sequía, los borregos cimarrones seleccionaron los sitios con baja cobertura vegetal (χ² = 11.58, P < 0.05), y durante el periodo de lluvias en solo una de las localidades de estudio seleccionaron los sitios con mayor cobertura vegetal (χ² = 8.72, P < 0.05). En el periodo de poslluvias, no se encontró una relación entre la cobertura vegetal y la distribución del borrego cimarrón. DISCUSIÓN Y CONCLUSIONES: La selección que hace el borrego cimarrón del terreno de escape y de la cobertura vegetal posiblemente se relaciona con su estrategia antidepredadora. El mayor registro de hembras (n = 140) y añeros (n = 62), aunado al hábitat no fragmentado y a la disponibilidad de agua permanente, confirman la importancia de Sierra Santa Isabel para la reproducción, crianza y reclutamiento del borrego cimarrón en Baja California. Los índices de vegetación derivados de imágenes de satélite miden solo el estado fenológico de la comunidad vegetal, pero no determinan qué especies se hallan presentes ni cuáles son utilizadas por el borrego cimarrón. No obstante, los índices de vegetación facilitan la identificación de áreas con una alta disponibilidad de alimento, información útil para definir sitios de muestreo previos a los monitoreos poblacionales de esta especie.

Introduction During the last decade we have observed important climate changes, especially in environmental temperatures. There is considerable information linking the increase in hot weather and human health. For example, hot weather is associated with an increased risk of suicide in different countries around the world. Objective To evaluate the relationship between suicide rates and the environmental temperature in Baja California Sur, Mexico, from 1985 to 2008. Method Suicide mortality data for Baja California Sur (BCS) were obtained for the years 1985-2008 from the Instituto Nacional de Estadística, Geografía e Informática (INEGI). The selected codes were: E950-E959 (ICD-9) and X60-X84, Y87.0 (ICD-10) for BCS. The BCS weather data used was the maximum temperature from 1985 to 2008, obtained from the Extractor Rápido de Información Climatológica (ERIC III). Lineal and quadratic models were used to assess the annual rate changes of suicide and generalized lineal models (GLM) to assess the effect of the climatological variables to the suicide rate. The p≤0.05 was considered significant. Results In BCS, 582 suicide deaths were reported from 1985 to 2008. The 9% (53) of the total reported were women with a yearly average rate 1.6/100 000; 91% (529) were men with a yearly average rate 16.3/100 000. Lineal and quadratic models explained the tendency of the annual increment observed in the number of suicides in both seasons. The quadratic model better explained such increment during the warmer months (R²=0.64 p<0.01). The temperature was positively correlated with the rate of suicides in both seasons (p<0.01). Two predictive GLMs were created by season. Discussion These results suggest a potential link between an increase in environmental temperature and the rates of suicide during 24 years in BCS. This relationship is clear during the hot season; however, a positive trend was found during the cold season, perhaps due to the result of warmer winters.

Introducción Durante las últimas décadas se ha podido apreciar un cambio en las variables climáticas, en especial en la temperatura ambiental. Hay evidencias que asocian el aumento de la temperatura ambiental con el incremento en las tasas de mortalidad por suicidio. Objetivo Evaluar la relación entre la tasa de suicidio y la temperatura ambiental en Baja California Sur (BCS) durante los años 1985-2008. Método Los datos de suicidio fueron obtenidos de las bases de Mortalidad del INEGI de 1985-2008. Se tabularon los registros con códigos: E950-E959 CIE-9 y X60-X84, Y87.0 CIE-10 para BCS. En el análisis climático se usaron las temperaturas máximas de 1985 al 2008 para BCS del Extractor Rápido de Información Climatológica (ERIC III). Para evaluar la tendencia, se utilizaron modelos de regresión lineal y cuadráticos. Los modelos lineales generalizados (GLM) se utilizaron para evaluar el efecto de las variables ambientales sobre la tasa de suicidios, con una significancia de p≤0.05. Resultados Un total de 582 suicidios ocurrieron en BCS de 1985 a 2008. Las mujeres representaron el 9% (53), con tasa anual promedio de 1.6/100 000. Los hombres 91% (529), con tasa promedio anual de 16.3/100 000. La tendencia de incremento anual se explicó con modelos lineales simples y cuadráticos en ambas temporadas. En los meses cálidos el modelo cuadrático explicó mejor dicho incremento (R²=0.64 p<0.01). La temperatura se correlacionó positivamente con la tasa en ambas temporadas (p<0.01). Se generaron dos modelos GLM predictivos por temporada. Discusión En este trabajo se observó una posible relación entre el incremento de la temperatura ambiental y el número de suicidios registrados durante 24 años en BCS. Esta relación se encuentra bien definida en los meses cálidos, pero con una tendencia en aumento para los meses fríos.

OBJECTIVE : To analyze the effect of a pilot program of tele-assistance and tele-alarms on the elderly’s self-perception of health status and to identify the satisfaction with and acceptance of the program. METHODS : Cross-sectional study that included interviews with 378 elderly individuals, 294 caretakers/relatives and 53 health care professionals. The program was run in Mexico City in 2010. The variables were socio-demographic characteristics, self-rated health, satisfaction and acceptance of the program. The information was gathered through a standardized questionnaire. The statistical analysis included descriptive analysis and nonparametric tests. RESULTS : Significant effects on self-perception of health were observed, 6.17 (SD 17.9 p < 0.05) points above the average. The program was well received and accepted by the elderly, family caregivers and health professionals. CONCLUSIONS : The program helps to maintain or improve quality of life, allows preventive care and is an ideal means of providing psychosocial support to the elderly.

OBJETIVO Analizar el efecto de un programa piloto de tele-asistencia y tele-alarma en la autopercepción del estado de salud de los adultos mayores y conocer la satisfacción y aceptación del programa. METODOS Estudio transversal que incluyó entrevistas a 378 adultos mayores, 294 cuidadores/familiares y 53 profesionales de la salud, realizado en la Ciudad de México en 2010. Variables sociodemográficas, de autopercepción del estado de salud, satisfacción y aceptación del programa se obtuvieron por medio de cuestionario estandarizado. Se realizó análisis descriptivo y se utilizaron pruebas no paramétricas. RESULTADOS Se observaron efectos significativos en la autopercepción del estado de salud, 6,17 (DE 17,9 p < 0,05) puntos por encima de la media. El programa tuvo una buena aceptación por parte de los adultos mayores, de sus cuidadores familiares y de los profesionales de la salud. CONCLUSIONES El programa contribuye a mantener o mejorar la calidad de vida, permite la atención preventiva y es un medio ideal para dar apoyo psicosocial a los adultos mayores.

OBJECTIVE : To analyze the effect of a pilot program of tele-assistance and tele-alarms on the elderly’s self-perception of health status and to identify the satisfaction with and acceptance of the program. METHODS : Cross-sectional study that included interviews with 378 elderly individuals, 294 caretakers/relatives and 53 health care professionals. The program was run in Mexico City in 2010. The variables were socio-demographic characteristics, self-rated health, satisfaction and acceptance of the program. The information was gathered through a standardized questionnaire. The statistical analysis included descriptive analysis and nonparametric tests. RESULTS : Significant effects on self-perception of health were observed, 6.17 (SD 17.9 p < 0.05) points above the average. The program was well received and accepted by the elderly, family caregivers and health professionals. CONCLUSIONS : The program helps to maintain or improve quality of life, allows preventive care and is an ideal means of providing psychosocial support to the elderly.

OBJETIVO Analizar el efecto de un programa piloto de tele-asistencia y tele-alarma en la autopercepción del estado de salud de los adultos mayores y conocer la satisfacción y aceptación del programa. METODOS Estudio transversal que incluyó entrevistas a 378 adultos mayores, 294 cuidadores/familiares y 53 profesionales de la salud, realizado en la Ciudad de México en 2010. Variables sociodemográficas, de autopercepción del estado de salud, satisfacción y aceptación del programa se obtuvieron por medio de cuestionario estandarizado. Se realizó análisis descriptivo y se utilizaron pruebas no paramétricas. RESULTADOS Se observaron efectos significativos en la autopercepción del estado de salud, 6,17 (DE 17,9 p < 0,05) puntos por encima de la media. El programa tuvo una buena aceptación por parte de los adultos mayores, de sus cuidadores familiares y de los profesionales de la salud. CONCLUSIONES El programa contribuye a mantener o mejorar la calidad de vida, permite la atención preventiva y es un medio ideal para dar apoyo psicosocial a los adultos mayores.

Introduction. We undertook this study in order to analyze the social care needs of users of the Immunodeficiency/HIV clinic of Hospital Infantil de Mexico Federico Gomez in Mexico City. Methods. A cross-sectional study was conducted with chil-dren and adolescents attending the clinic. Demographic, family and economic information were analyzed from the clinical files. Results. Included in the study were 177 patients: 25% were <5 years of age, 48% between 5 and 10 years, 13% between 10 and 15 years and 13% >15 years. Their educational level was below the expected average. Of these children, 53% are cared for by their parents, 28% by close relatives and 17% reside in shelters; 70% of parents suffer from HIV-AIDS and 87% of families have a monthly average income of MXN$2 644.00, from which 62% is allocated for food and 9% for medical care. Most of the "breadwinners" are marginally employed. All patients receive free medication covered by the Sistema de Protección Social en Salud. Conclusion. Children and adolescents with AIDS and their families have severe conditions of social vulnerability and little possibility for developing their educational and occupational capabilities. Expanding the capacity of the Immunodeficiency/ HIV clinic to provide social care will fulfill an unmet need.

Introducción. Objetivo: analizar las necesidades de atención social a la salud de pacientes atendidos en la Clínica para niños con Inmunodeficiencias/VIH-SIDA del Hospital Infantil de México Federico Gómez. Métodos. En el año 2008 se condujo un estudio transversal con niños y adolescentes usuarios de la clínica para niños con inmunodeficiencias. Se analizó la información demográfica, familiar y económica contenida en los expedientes sociales. Resultados. Se analizaron 177 pacientes: 25% menores de 5 años de edad, 48% tenían entre 5 y 10 años, 13% de 10 a 15 años y 13% mayores de 15 años; 53% recibía cuidado parental, 28% por familiares cercanos y 17.5% estaba en albergues. La escolaridad se observó por debajo del promedio esperado; 70% de los padres (madre, padre o ambos) tenía VIH-SIDA. El ingreso promedio mensual de 87.8% de las familias fue de $2 644.00 MN; del cual, 62% se destinaba para gastos de alimentación y 9% para servicios médicos. Los ingresos provenían del mercado informal. Todos los pacientes recibían los medicamentos gratuitamente a través del Sistema de Protección Social en Salud (Seguro Popular). Conclusión. Los pacientes y sus familias tenían severas condiciones de vulnerabilidad social y escasa posibilidad para desarrollar competencias educativas y laborales. Por lo que es indispensable incrementar la capacidad institucional de la Clínica de Inmunodeficiencia/VIH-SIDA para otorgar atención social.