La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos del Huila, Caquetá y Tolima

Al presentar el documento donde se hace un análisis del ejercicio del Diplomado de Profundización y Acompañamiento Psicosocial, plantea contextos reales, como los enfoques narrativos, la observación y el análisis de los componentes psicosociales referente a lo vivido el conflicto en Colombia. Se estudió el caso del relato del señor Modesto Pacaya, desmovilizado de la guerrilla, dice conscientemente no pretendió pertenecer a esa organización, se evidencia impactos psicosociales, por las experiencias traumáticas vividas, alejamiento de sus seres queridos, el trabajo lo llevaba a estar fuera de la constitución por la pertenencia a este grupo subversivo, de tal forma se trazaron unas preguntas circulares, reflexivas y estratégicas a partir la visión psicosocial. Así, mismo se realizó el análisis de la comunidad de peñas coloradas, se encuentra establecida en el departamento del Caquetá, fundada por hombres y mujeres laboriosas en el campo, con el tiempo se vieron en la necesidad de trabajar con hoja de coca traída del Perú (coca pajarita),al mimos tiempo apareció la guerrilla de las Farc, el gobierno propuso la sustitución de cultivos, el Estado no sabía de la existencia de la comunidad, con la propuesta los reconoció, tildándolos de formar el grupo subversivo, ahí comienza el trauma para la población dejando abandonado todo; como psicólogos en formación presentamos estrategias de intervención psicosocial que beneficien a la comunidad desterrada. Lo afirma White, (2016) “Cuantos de ustedes cuando miran hacia atrás algún evento estresante, y recuerdan la forma en que respondieron en aquel contexto, piensan “sí, seguro que era yo, pero no era yo mismo” (P.3). De igual manera se recopilo las experiencias de foto voz, realizamos una rápida leída de los escenarios que viven o vivieron las comunidades de las ciudades de la Montañita, Neiva, Armero, La Plata, la aptitud resiliente y empoderada de las comunidades esta creada en un Wix que hace parte de este trabajo.In this document where are made the analysis of the excercise about of Diploma off dee ping and psychosocial accompaniment. This proyect proposes real contexts such a narrative approaches, observation and analysis of psychosocial factors refering to how the Colombia conflict has been experienced. The relato of Modesto Pacaya was studied, he is a demobilized of the guerrilla. Who tells, he didnit want to be part of this organization. The psychosocial impacts are evident, due the traumatic experiences lived, there, the forced removal from family. For belonging to this subversive group. His work led him to be outside of the contitution, for this reason some circular reflexive, and strategic questions were designed from the psychosocial point of view. Likewise, the analysis of the Peñas Coloradas, comunity was carried out. This comunity is stablished in Caquetá, south of Colombia. It was founded by men and women, they were farmworkers but over the time and for necessity, they were forced to work cultivating coca leaves a kind carried from Peru at the sometime the FARC guerrilla appeored, inmediatly the goverment proposed the crop subtitution. The state didn’t know the existence of them they were recognized when the goverment gave to know them the proposal. Then they were trated like subversives right know began the trauma of the entire population. For this couse they abandoned their things there. Like psychologist in formation, we present some psychosocial strategies that can give benefits to all exilied population. On affirmation of White, (2016) "How many of you when looking back to a stressful event and remember the form that you answered in front this context, you tell: I was, yes, but it wasn't my self" (P.3). Many experiences a cross of photo-voice were collected, we dis a fast reading of the situation that lives or lived different comunities of the cities like Neiva, la Montañita, Armero, la Plata, amany others. The resilient and empowered ftnes of this comunities is embodied in a wix attached in this work

Obesity and brain structure in schizophrenia - ENIGMA study in 3021 individuals

Schizophrenia is frequently associated with obesity, which is linked with neurostructural alterations. Yet, we do not understand how the brain correlates of obesity map onto the brain changes in schizophrenia. We obtained MRI-derived brain cortical and subcortical measures and body mass index (BMI) from 1260 individuals with schizophrenia and 1761 controls from 12 independent research sites within the ENIGMA-Schizophrenia Working Group. We jointly modeled the statistical effects of schizophrenia and BMI using mixed effects. BMI was additively associated with structure of many of the same brain regions as schizophrenia, but the cortical and subcortical alterations in schizophrenia were more widespread and pronounced. Both BMI and schizophrenia were primarily associated with changes in cortical thickness, with fewer correlates in surface area. While, BMI was negatively associated with cortical thickness, the significant associations between BMI and surface area or subcortical volumes were positive. Lastly, the brain correlates of obesity were replicated among large studies and closely resembled neurostructural changes in major depressive disorders. We confirmed widespread associations between BMI and brain structure in individuals with schizophrenia. People with both obesity and schizophrenia showed more pronounced brain alterations than people with only one of these conditions. Obesity appears to be a relevant factor which could account for heterogeneity of brain imaging findings and for differences in brain imaging outcomes among people with schizophrenia

Country-level gender inequality is associated with structural differences in the brains of women and men

男女間の不平等と脳の性差 --男女間の不平等は脳構造の性差と関連する--. 京都大学プレスリリース. 2023-05-10.Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women’s worse outcomes in gender-unequal countries. We examined this through a random-effects meta-analysis on cortical thickness and surface area differences between adult healthy men and women, including a meta-regression in which country-level gender inequality acted as an explanatory variable for the observed differences. A total of 139 samples from 29 different countries, totaling 7, 876 MRI scans, were included. Thickness of the right hemisphere, and particularly the right caudal anterior cingulate, right medial orbitofrontal, and left lateral occipital cortex, presented no differences or even thicker regional cortices in women compared to men in gender-equal countries, reversing to thinner cortices in countries with greater gender inequality. These results point to the potentially hazardous effect of gender inequality on women’s brains and provide initial evidence for neuroscience-informed policies for gender equality

Country-level gender inequality is associated with structural differences in the brains of women and men

Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women's worse outcomes in gender-unequal countries. We examined this through a random-effects meta-analysis on cortical thickness and surface area differences between adult healthy men and women, including a meta-regression in which country-level gender inequality acted as an explanatory variable for the observed differences. A total of 139 samples from 29 different countries, totaling 7,876 MRI scans, were included. Thickness of the right hemisphere, and particularly the right caudal anterior cingulate, right medial orbitofrontal, and left lateral occipital cortex, presented no differences or even thicker regional cortices in women compared to men in gender-equal countries, reversing to thinner cortices in countries with greater gender inequality. These results point to the potentially hazardous effect of gender inequality on women's brains and provide initial evidence for neuroscience-informed policies for gender equality

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

The incidence of non-affective psychotic disorders in low and middle-income countries:a systematic review and meta-analysis

Purpose: Global understanding of the epidemiological landscape of non-affective psychotic disorders (NAPD) is predominantly based on studies from high-income countries. We sought to systematically review and meta-analyse all incidence studies conducted in low and middle-income countries (LMICs). Methods: We systematically searched four databases using terms for NAPD, incidence and LMICs. Citations were eligible for inclusion if: published between 1 January 1960 and 31 May 2022; wholly or partially conducted in an LMIC, and; containing data on NAPD incidence in the general adult population. Two independent raters assessed study quality according to previously published criteria. We conducted a narrative synthesis and random-effects meta-analyses where sufficient studies were available (N ≥ 5). Results: We retrieved 11 421 records, of which 23 citations met inclusion criteria from 18 unique studies across 19 settings in 10 LMICs. Median study quality was 4 out of 7 (interquartile range: 3–6). The crude incidence of NAPD varied around 4.2 times, from 10.0 per 100,000 person-years (95% confidence interval [CI] 8.7–11.4) in Brazil to 42.0 (95%CI 32.2–54.8) in India, with marked heterogeneity in methodologies and rates. Our 60-year review highlights the dearth of robust evidence on the incidence of psychotic disorders in LMICs. Conclusion: Without reliable, contemporary estimates of this fundamental cornerstone of population health, it is impossible to understand the true burden, distribution or causes of psychotic disorders in over 87% of the world’s population. A new, more equitable global mental health evidence base for NAPD is now urgently required

Structural brain abnormalities in schizophrenia in adverse environments:Examining the effect of poverty and violence in six Latin American cities

Summary Background Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. Aims We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. Method This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. Results A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R =-0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure. Conclusions Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- A nd middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.Fil: Crossley, Nicolas A.. Pontificia Universidad Católica de Chile; ChileFil: Zugman, Andre. Universidade Federal de Sao Paulo; BrasilFil: Reyes Madrigal, Francisco. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Czepielewski, Leticia S.. Universidade Federal do Rio Grande do Sul; BrasilFil: Castro, Mariana Nair. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Salud Mental; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia. Instituto de Neurociencias - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Neurociencias; ArgentinaFil: Diaz Zuluaga, Ana M.. Universidad de Antioquia; ColombiaFil: Pineda Zapata, Julian A.. No especifíca;Fil: Reckziegel, Ramiro. Universidade Federal do Rio Grande do Sul; BrasilFil: Gadelha, Ary. Universidade Federal de Sao Paulo; BrasilFil: Jackowski, Andrea. Universidade Federal de Sao Paulo; BrasilFil: Noto, Cristiano. Universidade Federal de Sao Paulo; BrasilFil: Alliende, Luz M.. Pontificia Universidad Católica de Chile; ChileFil: Iruretagoyena, Barbara. Pontificia Universidad Católica de Chile; ChileFil: Ossandon, Tomas. Pontificia Universidad Católica de Chile; ChileFil: Ramirez Mahaluf, Juan P.. Pontificia Universidad Católica de Chile; ChileFil: Castañeda, Carmen P.. Instituto Psiquiátrico Dr. José Horwitz Barak; ChileFil: Gonzalez Valderrama, Alfonso. Universidad Finis Terrae; ChileFil: Nachar, Ruben. Instituto Psiquiátrico Dr. José Horwitz Barak; ChileFil: León Ortiz, Pablo. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Undurraga, Juan. Universidad del Desarrollo; ChileFil: López Jaramillo, Carlos. Universidad de Antioquia; ColombiaFil: Guinjoan, Salvador Martín. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Salud Mental; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia. Instituto de Neurociencias - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Neurociencias; ArgentinaFil: Gama, Clarissa S.. Universidade Federal do Rio Grande do Sul; BrasilFil: De La Fuente Sandoval, Camilo. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Bressan, Rodrigo A.. Universidade Federal de Sao Paulo; Brasi