Prevalence and associated factors to suicide attempts in low-income adolescents from the Caribbean region of Colombia

Objectives to establish the prevalence and associated factors to suicide attempts (SA) in low-income adolescents from the Caribbean region of Colombia Methods A cross sectional study was conducted. Adolescents between 10-24 years of age residents in 21 municipalities in the Caribbean region of Colombia were randomly selected from the population affiliated to a subsidized-regime insurance company between 2014-2018. A previously constructed questionnaire was used to obtain information regarding sociodemographic variables and potential risk factors. A self-reported antecedent of suicide attempt was defined as a case. Bivariate and multivariate logistic regression models were used to establish associated factors. Absolute and relative frequencies were reported. Relative frequencies were compared with the Chi2 test and continuous variables were compared with the t-test. A p value <0.050 was considered significan

Burden of disease in young population of a colombian health insurance company

To estimate the burden of disease of population between 10-24 years old enrolled in the SER JOVEN program of a Colombian insurance company using disability-adjusted life-years (DALYs). Incidences were estimated from the administrative claims data of Mutual SER EPS. The ICD-10 codes of the main diagnosis were identified and regrouped according to the categories of diseases reported in the global burden of disease (GBD) study. To estimate the years of life lost (YLL), the difference between the age of death and the life expectancy at that age was obtained in a reference mortality population. The years lived with disability (YLD) were obtained by multiplying the estimated morbidity and the disability weights of the GBD 2017. DALYs were calculated by adding YLD and YLLs. We used the information of 512 patients insured to Mutual SER-EPS between 10-24 years, who died during January 2015 to December 2017 from all causes, and the healthcare registers of young people aged 10-24 years residing in 21 municipalities where Mutual SER EPS has presence. In the studied population, premature deaths and disability produced 5,355 DALYs, for 2017. Of these, 67.1% (3,591) of the burden of disease was due to non-communicable causes; followed by communicable, maternal, neonatal, and nutritional diseases (15.9%). The remaining 17% were due to unintentional and vital injuries and unclassified causes. The specific causes with the highest reported burden were substance use disorders and mental disorders, and this relationship remained constant between 2015-2017. In both sexes the first cause was non-communicable diseases; in men, injuries; and in women, communicable, maternal, neonatal diseases. In the analyzed population there was a considerable burden of disease associated with mental disorders and substance use. It is recommended to implement effective strategies that allow prioritizing the diseases that generate the greatest burden

Adherence to long-acting reversible contraceptive methods in low- income young women from the caribbean region of Colombia

Adolescent pregnancies are more likely to occur in poor communities, commonly driven by lack of education and employment opportunities. We aimed to estimate the subdermal implant discontinuation rate and to establish the factors associated with the discontinuation of long-acting reversible contraceptive (LARC) methods in a cohort of poor women in the Caribbean region of Colombia. A retrospective cohort study of LARC method use through review of administrative record data was conducted. A population of 2,192 adolescents and young women between 10-24 years old enrolled in the “SER JOVEN” program and who received subdermal implants between 2015-2018 was considered for eligibility. This program is for young people affiliated to a health care company in the Caribbean region of Colombia. We realized a follow-up time-person of the retrospective cohort, and we estimated the incidence of discontinuation of the subdermal implant at six months, one year, two years, and three years. Kaplan-Meier estimator for survival curves, and Cox proportional hazard model were used to ascertain factors associated with method discontinuation risk. A p-value <0.050 was considered significant. A total of 2,192 women were selected with a mean (standard deviation -SD) age of 19.4 (2.8) years and a mean duration of use of subdermal implant of 2.6 (0.8) years. We estimated the subdermal implant discontinuation rate at six months in 0.7% [CI95% 0.3-1.1], a year later in 1.5% [CI95% 1-2], two years later in 2.1% [CI95% 1.5-2.7] and finally at three years in 2.2% [CI95% 1.6-2.8]. Women who stated they have children at baseline were about 70% less risk to discontinue subdermal implants (HR: 0.3 [CI95% 0.1 – 0.8]). Adolescent pregnancy is a public health problem, and it is an important cause of poverty and illness. Then, the use of subdermal implants is an effective alternative to prevent unintended pregnancies

Knowledeges and experiences of pregnant women on prenatal care programs of a subsidized health care company from the Caribbean region of Colombia: a qualitative analysis

Objectives: Prenatal care programs have been conceived to reduce maternal and perinatal mortality risk. However, some pregnant women arrive late or do not attend the program, thus, health risks associated with pregnancy increases considerably. The objective of this study was to know pregnant women perceptions about a prenatal care program that include two components: health services and educational advice. Methods: A randomized sample of 33 women was chosen. Inclusion criteria considered women between 30 and 32 gestation weeks of pregnancy and living in the urban area. Data was collected using the focus group technique. For the analysis, we used the following protocol: Literal transcription of oral speech, information coding and integration, and data triangulation. Qualitative analysis with textual data was conducted with Quanteda package in R statistical software. Results: Important differences were found by geographic zones. In the city, pregnant women associate the program mainly with health services, while women living in town area associate the program with the educational component. Also, in the city the first contact with the program was by the prenatal care appointment, while in town was through the educational agents from the health care company. The program is valued in special form by women with high risk pregnancy and first-time mothers like a mechanism to guarantee their wellbeing and the baby’s. On the other hand, women that planned their pregnancy, began early prenatal check-ups than those who did not planned it. Conclusions: In the design of prenatal care programs sociocultural differences of communities to which they target as well as the perceptions, realities, and motivations of pregnant women must be considered. This would allow having better results in maternal and perinatal health and public health as a result of a more comprehensive intervention

Markers of endothelial damage in patients with chronic kidney disease on hemodialysis

Patients with Stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins (Ang) to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (Madrid, Spain): 80 patients with DM and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD142+/CD16+, CD14+/CD162+) were analyzed by flow cytometry, and the plasma concentrations of Ang1 and Ang2 were quantified by ELISA. Data on CVD were gathered over the 5.5 yr after these samples were obtained. MV level, monocyte subpopulations (CD14+/CD162+ and CD142+/CD16+), and Ang2-to-Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) was associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2-to-Ang1 ratio can be used as predictors for CVD. In addition, MV level has a potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.Support for this work was provided by Plan Nacional de IDi Proyectos de Investigación en Salud of Instituto de Salud Carlos III (ISCIII)–Subdirección General de Evaluación, Fondos de desarrollo regional (FEDER; PI11/01536, PI12/01489, PI14/00806, PI15/01785); Junta de Andalucía grants (P010-CTS-6337, P11-CTS-7352); and Fundación Nefrológica. P. Buendía, A. Carmona, and C. Luna-Ruiz are fellows from Consejería de Innovacion, Ciencia y Empresa, Junta de Andalucía

patrimonio intelectual

Actas de congresoLas VI Jornadas se realizaron con la exposición de ponencias que se incluyeron en cuatro ejes temáticos, que se desarrollaron de modo sucesivo para facilitar la asistencia, el intercambio y el debate, distribuidos en tres jornadas. Los ejes temáticos abordados fueron: 1. La enseñanza como proyecto de investigación. Recursos de enseñanza-aprendizaje como mejoras de la calidad educativa. 2. La experimentación como proyecto de investigación. Del ensayo a la aplicabilidad territorial, urbana, arquitectónica y de diseño industrial. 3. Tiempo y espacio como proyecto de investigación. Sentido, destino y usos del patrimonio construido y simbólico. 4. Idea constructiva, formulación y ejecución como proyecto de investigación. Búsqueda y elaboración de resultados que conforman los proyectos de la arquitectura y el diseño

CLASSIFICATION OF STRENGTHENING EXERCISES OF THE LOWER MEMBER POSTERIOR CHAIN, BASED ON THE AMPLITUDE OF MUSCULAR ACTIVATION IN AMATEUR SOCCER PLAYERS BETWEEN 18-25 YEARS

The hamstring injuries are recurrent in the sports disciplines of teams such as football, with rehabilitation being a key point to prevent future alterations. Within this process, the strengthening paradigms are rather empirical, therefore, criteria based on the exercises used are required. In this context, the objective of the present investigation is to classify the strengthening exercises of the posterior lower limb chain, based on the amplitude of muscular activation, in amateur soccer players of the Andres Bello University (UNAB), for which a non-experimental, descriptive, cross-sectional design. The study population was 30 university students, who were studying from first to fifth year, during the academic period 2017. The participants were summoned to the Laboratory of Rehabilitation Sciences, where after signing the informed consent they had to perform a phase of heating on a cycle ergometer, then the MCIV (maximum voluntary isometric contraction) of the semimembranous, semitendinous, biceps femoral and gluteus maximus muscles was calculated, finally applying a battery of strengthening exercises, which were classified according to the intensity of muscle activation. In relation to this, it was obtained that 8 of the 13 exercises implemented were classified as low intensity (p <0.05), 3 of medium intensity (p <0.05) and 2 of high intensity (p <0.05), while the peak of amplitude of the semimembranous, semitendinous and biceps femoral muscles moved to the right in temporal terms, to the extent that the exercises classified as low, medium and high intensity are compared

EPH22 Prevalence and risk factors of post COVID-19 condition in previously hospitalized patients in Bolivar, Colombia: an observational study

Objectives: To estimate the prevalence and risk factors of post-COVID-19 condition after at least three months of hospital discharge in a retrospective cohort of patients from a health insurance company (Mutual SER EPS) living in the north of Bolivar, a department of Colombia. Methods: Clinical and sociodemographic data were collected from 181 COVID-19 patients who were hospitalized in the ward or intensive care unit (ICU) between March-2021 to August-2021. Patients who agreed to participate were evaluated by a structured telephone interview to identify persistent or new symptoms after at least three months of hospital discharge. Associations between at least one symptom and clinical and sociodemographic characteristics at admission were assessed through bivariate and multivariate logistic regression using a stepwise Akaike information criterion (AIC) selection. Adjusted odds ratios (aOR) are reported. Results: Mean age of patients was 56 years (SD: 17 years), 50.8% (n=92) were women and 23.2% (n=42) were previously admitted to ICU. One-hundred-three patients (56.9%) had at least one comorbidity; being hypertension (36.5%), type 2 diabetes mellitus (18.2%) and heart disease (8.28%) the most common. The presence of at least one symptom after three months of hospital discharge was reported by 141 (77.9%) patients. Most frequently symptoms were fatigue (54.1%), joint pain (45.3%), dyspnea (43.1%), sleep disorders (36.5%), chest pain (30.4%), and anorexia (30.4%). Symptoms were significantly more frequent in women (aOR: 2.45, 95% CI 1.14- 5.29, p=0.02) and ICU admitted patients (aOR: 3.10, 95% CI 1.02-9.45 p=0.05), but were not associated with age, having comorbidities, or a previous long hospital stay. Conclusions: As reported in other studies, in Bolivar -Colombia, the presentation of post COVID-19 symptoms is frequent in previously hospitalized patients. Being a wome

Desnutrición y vacunación en niños: caso de zona de postconflicto en el caribe colombiano

Objectives To establish the association between malnutrition and vaccination and its socioeconomic determinants in children from a post-conflict zone. Methods a sample of 2,183 households with 2,682 children of 0-4 years was extracted from a survey of more than 15,000 persons. Indicators as weight-for-height, height-for-age and weight-for-age were calculated according to the World Health Organization standards. Vaccination status was checked by comparing the report of the vaccination card with the scheme of the Expanded Immunization Plan for the Pentavalent vaccine (Hepatitis B, Haemophilus Influenzae type B and Diphtheria - Whooping cough - Tetanus) for children 2-59 months and the scheme of BCG Tuberculosis and Hepatitis B for children <2 months. A logistic model with clusters per community was estimated to identify factors associated with malnutrition and vaccination. Results The prevalence of low weight, acute and chronic malnutrition was 2.4%, 5.5%, and 8.6% respectively. 96.3% of the children had their vaccines at the right age. Timely vaccination protects against global and acute malnutrition (OR: 0.244 and 0.357 p <0.001). Children with an incomplete vaccination scheme have a 4.6% probability of being underweight, and 12.1% of having acute malnutrition. The education of the mother (OR: 0.543 and 2.269 p <0.001), the socioeconomic level of the household (OR: and 0.811, and 2.631 p <0.001) and the dependency rate of the child under 5 years (OR: 1.22 and 0,546 p <0.001) are common determinants between acute malnutrition and child vaccination status, respectively. Conclusions This article provides evidence of timely vaccination at age as a protective factor for global and acute malnutrition. In addition, it shows the double effect of the socioeconomic conditions of households in the determination of vaccination and the nutritional status of children.Los objetivos Establecer la asociación entre la desnutrición y la vacunación y sus determinantes socioeconómicos en niños de una zona de postconflicto. Los metodos de una encuesta de más de 15,000 personas se extrajo una muestra de 2,183 hogares con 2,682 niños de 0 a 4 años. Los indicadores como peso para la altura, altura para la edad y peso para la edad se calcularon de acuerdo con los estándares de la Organización Mundial de la Salud. El estado de la vacunación se verificó comparando el informe de la tarjeta de vacunación con el esquema del Plan de inmunización ampliado para la vacuna pentavalente (hepatitis B, Haemophilus Influenzae tipo B y Difteria - tos ferina - tétanos) para niños de 2 a 59 meses y el esquema de BCG Tuberculosis y hepatitis B para niños <2 meses. Se estimó un modelo logístico con grupos por comunidad para identificar los factores asociados con la desnutrición y la vacunación. Resultados La prevalencia de desnutrición de bajo peso, aguda y crónica fue de 2.4%, 5.5% y 8.6% respectivamente. El 96,3% de los niños se vacunaron a la edad adecuada. La vacunación oportuna protege contra la desnutrición global y aguda (OR: 0.244 y 0.357 p <0.001). Los niños con un esquema de vacunación incompleto tienen un 4,6% de probabilidad de tener bajo peso y el 12,1% de tener desnutrición aguda. La educación de la madre (OR: 0.543 y 2.269 p <0.001), el nivel socioeconómico del hogar (OR: y 0.811, y 2.631 p <0.001) y la tasa de dependencia del niño menor de 5 años (OR: 1.22 y 0.546 p <0,001) son determinantes comunes entre la desnutrición aguda y el estado de vacunación infantil, respectivamente. Conclusiones Este artículo proporciona evidencia de la vacunación oportuna a la edad como factor protector para la desnutrición global y aguda. Además, muestra el doble efecto de las condiciones socioeconómicas de los hogares en la determinación de la vacunación y el estado nutricional de los niños

Situación nutricional en sub - 5 en "montes de maria", zona de postconflicto en colombia- 2017

Objectives To estimate the nutritional status in children under 5 in “Montes de María”, a post-conflict zone in Colombia- 2017. Methods Cross sectional observational study that use data from a survey of 15,230 households with subsidized health care insurance. From these, 2,682 children between 0-4 years with anthropometric information from 2,183 households were included. Based on the World Health Organization standards, weight and height information were used to calculate the Z-score indicator = weight-for-height (W/H), height-for-age (H/A) and weight-for-age (W/A). Z-score categories were defined as: well fed (±2), malnourished (<-2), severely malnourished (<-3). Prevalence of nutritional states were estimated and association among children characteristics, households and nutritional status were validated through Chi-X2 test. Results Prevalence of low weight, acute and chronic malnutrition was 2.4%, 5.5% and 8.6% respectively. Group of 0-1 years was the most prevalent in acute (6.7%) and chronic (9.6%) malnutrition. There were significant differences in prevalence between children ages (Pr<0.001) in all of three indicators, except in the prevalence of low weight for sex (Pr<0.05). Age of the head of household (Pr=0.027), education of the head of household (Pr=0.001), education of mother (Pr=0.001), number of people in household (Pr=0.001) were significantly associated with growth retardation of children. Conclusions In this study, acute malnutrition is higher than national level (0.9%), being children of <1 year those who presented higher malnutrition compared with the national level. Health policies related with early childhood in vulnerable population must be improved in order to reduce these figures.Los objetivos Para estimar el estado nutricional en niños menores de 5 años en “Montes de María”, una zona de posconflicto en Colombia- 2017. Los metodos Estudio observacional transversal que utiliza datos de una encuesta de 15,230 hogares con seguro de salud subsidiado. De estos, 2,682 niños entre 0 y 4 años con información antropométrica de 2,183 hogares fueron incluidos. Sobre la base de los estándares de la Organización Mundial de la Salud, la información de peso y talla se utilizó para calcular el indicador de puntuación Z = peso para la altura (W / H), altura para la edad (H / A) y peso para la edad ( WASHINGTON). Las categorías de puntuación Z se definieron como: bien alimentadas (± 2), desnutridas (<-2), gravemente desnutridas (<-3). Se estimó la prevalencia de estados nutricionales y se validó la asociación entre las características de los niños, los hogares y el estado nutricional mediante la prueba Chi-X2. Resultados La prevalencia de desnutrición de bajo peso, aguda y crónica fue de 2.4%, 5.5% y 8.6% respectivamente. El grupo de 0-1 años fue el más prevalente en desnutrición aguda (6.7%) y crónica (9.6%). Hubo diferencias significativas en la prevalencia entre las edades de los niños (Pr <0,001) en los tres indicadores, excepto en la prevalencia de bajo peso para el sexo (Pr <0,05). La edad del jefe de hogar (Pr = 0.027), la educación del jefe de hogar (Pr = 0.001), la educación de la madre (Pr = 0.001), el número de personas en el hogar (Pr = 0.001) se asoció significativamente con el retraso del crecimiento de niños. Conclusiones En este estudio, la desnutrición aguda es más alta que el nivel nacional (0,9%), siendo niños de <1 año los que presentaron mayor desnutrición en comparación con el nivel nacional. Las políticas de salud relacionadas con la primera infancia en la población vulnerable deben mejorarse para reducir estas cifras