Can a conditional cash transfer reduce teen fertility? The case of Brazil’s Bolsa Familia

In 2008, Brazil's conditional cash transfer program expanded to cover a wider range of ages. Poor families are now given stipends for their children's school attendance up to age seventeen, whereas prior the maximum age was fifteen. Using a nationally representative household survey, we estimate the impact of this policy on teen fertility with a triple difference analysis on the fertility outcomes of treated cohorts vs. non-treated cohorts based on income eligibility, age eligibility, and timing of program implementation. We find a three percentage point drop in fertility among eligible teens within five years of program implementation. This offsets the difference in fertility between poor and non-poor teens. The impact is concentrated in urban areas, with no program effects found in rural areas. We are able to replicate these findings using National Birth Registry Data.     

Risk of child poverty and social exclusion in two Spanish regions: social and family determinants

ObjectiveDescribe the risk of poverty and social exclusion in children aged 8-11 years from Gipuzkoa and Valencia (Spain), through AROPE (At Risk Of Poverty or Social Exclusion) indicators, and evaluate their associated factors in the INMA Project (Childhood and Environment).MethodFamilies in Gipuzkoa and Valencia (394 and 382, respectively) completed a questionnaire in 2015-2016. Low work intensity (LWI), at risk of poverty (RP) and material deprivation (MD) were estimated. AROPE consisted in meeting any of the previous sub-indicators. Socio-demographic, family and parental characteristics were considered. Frequencies, Venn's diagrams, and chi-square and Fisher tests were used in bivariate analysis and logistic regression in multivariate analysis.ResultsFor LWI, RP, MD and AROPE, prevalence of 2.5%, 5.6%, 2.3% and 7.2% were obtained in Gipuzkoa, and 8.1%, 31.5%, 7.8% and 34.7% in Valencia, respectively. In the multivariate analysis, the AROPE was associated in both areas with maternal social class and non-nuclear families. In Gipuzkoa, it was also related to maternal education. In Valencia, other factors were the mother's foreign origin, and paternal education and smoking.ConclusionThere is higher AROPE prevalence in Valencia. Social class and family type were shared factors, but a differential pattern is observed in other social determinants. It is essential to implement social policies to reduce this axis of inequalities in health, especially in childhood.     

Tibial acceleration and shock attenuation while running over different surfaces in a trail environment

ObjectivesIncreased tibial axial acceleration and reduced shock attenuation are associated with running injuries and are believed to be influenced by surface type. Trail running has increased in popularity and is thought to have softer surface properties than paved surface, but it is unclear if trail surfaces influence tibial acceleration and shock attenuation. The purpose of this study was to investigate peak triaxial and resultant tibial acceleration as well as axial and resultant shock attenuation among dirt, gravel, and paved surfaces.DesignFifteen recreational runners (12 females, 3 males, age = 27.7 ± 9.1 years) ran over dirt, gravel, and paved surfaces in a trail environment while instrumented with triaxial tibial and head accelerometers.MethodsDifferences between tri-planar peak tibial accelerations (braking, propulsion, axial, medial, lateral, and resultant) and shock attenuations (axial and resultant) among surface types were assessed with one-way ANOVAs with Bonferroni post-hoc tests.ResultsNo significant differences were found for tibial accelerations or shock attenuations among surface types (p > 0.05).ConclusionsDirt and gravel trail running surfaces do not have lower tibial accelerations or greater shock attenuation than paved surfaces. While runners are encouraged to enjoy the psychological benefits of trail running, trail surfaces do not appear to reduce loading forces associated with running-related injuries.     

Evaluación del impacto de un plan multisectorial de promoción de la salud y el bienestar social en Andalucía

ObjectiveTo evaluate the impact of the Plan for the promotion of personal autonomy and prevention of disability in Andalusia (2016-2020) in 13 public administrations during the first year of its implementation; and to analyse the usability and feasibility of the impact assessment ladder used.MethodThe Plan addresses the promotion of personal autonomy and the prevention of disabilities and dependencies through a multisectoral approach. It is structured in strands or lines of work, objectives and actions that have been assessed through the Adoption Impact Ladder (AIL). The analysis of the face validity, feasibility and inter-rater reliability of the impact assessment ladder was carried out in 30 actions of the Plan that were rated by 20 experts from the 13 ministries and public agencies involved in the Plan, and an external rater.Results176 actions and programmes were launched in 2017. Of these, 67.2% were implemented during the first year. Only one of the 16 objectives had no action initiated during the first year. Moreover, 7 out of 15 objectives implemented were fully multisectoral involving more than three Regional Ministries. The face validity, feasibility and inter-rater reliability of the AIL were good (κ: 0.72).ConclusionsThis Plan has provided a novel framework to coordinate a broad range of proposed policies and actions within the public administration of Andalusia. For the first time, a multisectoral impact analysis has been conducted providing an effective guide for monitoring, planning and setting public priorities in health, social services, ageing and disabilities.     

Do humor styles predict clinical response to the MINDSET (MINDfulneSs & EducaTion) program? A pilot study in patients with fibromyalgia

Background and aimHumor has been described as an effective coping strategy for dealing with chronic pain conditions; likewise, coping strategies predict some clinical outcomes after cognitive-behavioral therapy and mindfulness-based interventions. The present study aims to preliminarily explore the role of humor styles in predicting clinical changes after the multicomponent intervention (MINDSET) that combines mindfulness and psychoeducation for fibromyalgia (FM) patients.Material and methodsA subsample of 35 patients with FM of the EUDAIMON study, a randomized controlled trial, was used for the present study; linear regressions and Spearman's correlations were computed.ResultsAffiliative humor and positive/negative ratio humor styles had a unique predictive effect on self-reported clinical changes. Significant correlations between humor styles with functional impact and mindfulness facets were observed.ConclusionsSome humor styles may imply a better disposition in patients to learn and implement the concepts and resources that the intervention offered.     

新疆健康扶贫模式:结核病精准服务平台

通过对国内尤其是新疆结核病现状进行分析,阐述通过大数据和人工智能技术构建结核病精准防控体系，搭建“大数据智能监测、AI辅助诊断、AI临床诊疗管理、康复随访干预”四位一体，探索临床诊疗和公共卫生数据整合衔接的新疆模式。认为精准平台有利于早发现、早诊断，使上报，转诊、治疗、随访实现全流程的闭环管理，为西部地区传染病防治提供借鉴