Prevalência e fatores associados ao bullying em adolescentes

Introduction: Bullying is a complex and multifactorial social phenomenon, which refers to the exposure of different forms of abuse on a repetitive, systematic and intentional basis. Objective: To determine the prevalence and factors associated with bullying in adolescents at three public educational institutions. Materials and Methods: A cross-sectional analytical study was conducted with 816 adolescents covering sixth to ninth grades from three educational institutions in Bucaramanga, Colombia, who were evaluated in 2014 through self-administered questionnaires. Results: 84.2% of the school-going adolescents reported having witnessed any type of violence, of which 33.8% were victims and 22.3% were aggressors. Verbal violence prevailed at 80.1%, followed by physical violence at 47.7% and psychological violence at 36.9%. No relationship was found in the bivariate analysis between bullying and gender, school, school hours, academic year, type of family and their role as witnesses and victims. An association was found in the bivariate and multivariate analysis between school bullying and gender, type of family, smoking and consumption of energy drinks in the aggressor role. Discussion: The identification of the variables associated with school bullying facilitates prioritizing and guiding decisions that will be made regarding this issue. Conclusions: School bullying is a complex phenomenon that requires the articulation of the academic community, parents, healthcare professionals and local authorities. How to cite this article: Páez Esteban Astrid Nathalia, Ramírez Cruz María Angela, Campos de Aldana María Stella, Duarte Bueno Laura María, Urrea Vega Edwing Alberto. Prevalencia y factores asociados con el acoso escolar en adolescentes. Revista Cuidarte. 2020;11(3):e1000. http://dx.doi.org/10.15649/cuidarte.1000    Introducción: El acoso escolar es un fenómeno social, complejo y multifactorial, que hace referencia a la exposición de diferentes formas de maltrato de forma repetitiva, sistemática e intencionada. Objetivo: Determinar la prevalencia y los factores asociados con el acoso escolar en adolescentes de tres instituciones educativas públicas. Métodos: Estudio analítico de corte transversal, mediante una encuesta auto-administrada se evaluaron 816 adolescentes de sexto a noveno grado de tres instituciones educativas de Bucaramanga, Colombia en el año 2014. Resultados: El 84.2% de los adolescentes escolarizados manifestó haber sido testigo de cualquier tipo de violencia, víctima el 33.8% y victimario el 22.3%. Predominó la violencia verbal 80.1%, seguida de la física 47.7% y psicológica 36.9%. En el análisis bivariado no se encontró relación entre el acoso escolar y el sexo, el colegio, la jornada, el curso académico, el tipo de familia y su funcionalidad en los roles de testigos y víctimas. En el análisis bivariado y multivariado se encontró asociación del acoso escolar con el sexo, tipo de familia, consumo de cigarrillo y consumo de bebidas energizantes en el rol de victimario. Discusión: La identificación de las variables asociadas al acoso escolar permite priorizar y orientar las decisiones que se tomen entorno a la problemática.  Conclusiones: El acoso escolar es un fenómeno complejo que requiere la articulación de la comunidad académica, padres de familia, profesionales de la salud y autoridades territoriales. Como citar este artículo: Páez Esteban Astrid Nathalia, Ramírez Cruz María Angela, Campos de Aldana María Stella, Duarte Bueno Laura María, Urrea Vega Edwing Alberto. Prevalencia y factores asociados con el acoso escolar en adolescentes. Revista Cuidarte. 2020;11(3):e1000. http://dx.doi.org/10.15649/cuidarte.1000    Introdução: O bullying é um fenômeno social complexo e multifatorial, que se refere à exposição de diferentes formas de abuso de uma forma repetitiva, sistemática e intencional. Objetivo: Determinar a prevalência e os fatores associados ao bullying em adolescentes em três instituições públicas de ensino. Materiais e Métodos: Estudo analítico transversal no qual 816 adolescentes da sexta à nona série de três instituições de ensino em Bucaramanga, Colômbia foram avaliados através de uma pesquisa auto-administrada em 2014. Resultados: 84,2% dos adolescentes na escola afirmaram ter testemunhado qualquer tipo de violência, 33,8% sendo vítimas e 22,3% agressores. A violência verbal predominou em 80,1%, seguida da violência física em 47,7% e da violência psicológica em 36,9%. Na análise bivariada, não foi encontrada nenhuma relação entre bullying e sexo, escola, jornada escolar, ano lectivo, tipo de família e sua funcionalidade nos papéis de testemunhas e vítimas. Na análise bivariada e multivariada, encontramos uma associação entre bullying escolar e sexo, tipo de família, consumo de cigarros e consumo de bebidas energéticas, no papel do agressor. Discussão: A identificação das variáveis associadas ao bullying escolar permite priorizar e orientar as decisões tomadas sobre o problema. Conclusões: O bullying escolar é um fenômeno complexo que requer a articulação da comunidade acadêmica, dos pais, dos profissionais de saúde e das autoridades territoriais. Como citar este artigo: Páez Esteban Astrid Nathalia, Ramírez Cruz María Angela, Campos de Aldana María Stella, Duarte Bueno Laura María, Urrea Vega Edwing Alberto. Prevalencia y factores asociados con el acoso escolar en adolescentes. Revista Cuidarte. 2020;11(3):e1000. http://dx.doi.org/10.15649/cuidarte.1000   &nbsp

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Úlcera corneal micótica por lasiodiplodia theobromae. Reporte de caso.

Background: The corneal ulcer of mycotic etiology caused by Lasiodiplodia theobromae is an infrequent pathology with less than 50 cases of ocular infection by this pathogen reported in the literature.Objective: To present a case of a rare pathology, make a brief literature review, and discuss the chosen treatment that was favorable.Study design: Case reportCase summary: We present the case of a patient treated at the Hospital Universitario de Santander (HUS) during the years 2015 - 2017 with a history of ocular trauma with plant material who developed fungal corneal ulcer by Lasiodiplodia theobromae, which was confirmed using microbiological analysis of the corneal smear. Treatment with a combination of antifungals was established with a satisfactory final resultConclusion: L. theobromae is an opportunistic pathogen. The importance of early diagnosis in these cases, which requires a high index of suspicion in patients with plant trauma, with the identification of the etiological agent lies in avoiding or minimizing irreversible consequences through the establishment of an opportune treatment.Introducción: La úlcera corneal de etiología micótica por Lasiodiplodia theobromae es una patología infrecuente con menos de 50 casos de infección ocular por este patógeno reportados en la literatura.Objetivo: Dar a conocer un caso de una patología poco frecuente, haciendo una breve revisión de la literatura, y discutiendo el tratamiento elegido que resultó favorable.Diseño del estudio: Reporte de casoResumen del caso: Se presenta el caso de un paciente atendido en el Hospital Universitario de Santander (HUS) durante los años 2015 - 2017 con antecedente de trauma ocular con material vegetal quien desarrolla úlcera corneal micótica por Lasiodiplodia theobromae, que se confirmó usando análisis microbiológico del frotis corneal. Se instauró tratamiento con una combinación de antimicóticos con un resultado final satisfactorioConclusión: L. theobromae es un patógeno oportunista. La importancia del diagnóstico precoz en estos casos, que requiere un alto índice de sospecha en pacientes con trauma vegetal, con la identificación del agente etiológico radica en evitar o minimizar consecuencias irreversibles mediante la instauración de un tratamiento oportuno