La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos del Atlántico, Magdalena, Bolívar y Antioquia

El conflicto armado en Colombia ha dejado a lo largo de los más de 50 años de guerras y disputas, un sinnúmero de víctimas, violentadas física, sexual, psicológica y moralmente; niños, adolescentes, jóvenes, hombre y mujeres han padecido de este flagelo que genera un impacto psicosocial importante en el bienestar y desarrollo socioemocional de los individuos. El diplomado de acompañamiento psicosocial en escenarios de violencia, busca reconocer desde el enfoque narrativo y la mirada contextualizada del conflicto, las distintas afectaciones, traumas y procesos restaurativos en poblaciones víctimas del conflicto armado en Colombia. Como cumplimiento de este objetivo, se llevaron a cabo una serie de actividades descritas en el presente trabajo; la experiencia de foto voz aplicada en los departamentos del Atlántico, Magdalena, Bolívar y Antioquia; el análisis de los relatos Carlos Arturo y Peñas Coloradas, donde se contextualizan los impactos psicosociales, las voces y significados en relación a la imagen dominante de la violencia, los posicionamientos resilientes y afrontativos ante las experiencias traumáticas en las victimas; se describen una serie de informes analíticos de los relatos, preguntas circulares, estratégicas y reflexivas del relato Carlos Arturo, y además se evidencia el diseño de estrategias psicosociales para el fortalecimiento de la comunidad Peñas Coloradas. Como conclusión se reconocen las distintas miradas y subjetividades inmersas en los escenarios de violencia, mediante el abordaje de casos y herramientas disciplinares del diplomado; orientando al estudiante de psicología en el reconocimiento del acompañamiento psicosocial a víctimas del conflicto.The armed conflict in Colombia has left throughout the more than 50 years of wars and disputes, countless victims, physically, sexually, psychologically and morally violated; children, adolescents, young people, men and women have suffered from this scourge that generates a significant psychosocial impact on the well-being and socio-emotional development of individuals. The psychosocial accompaniment course in scenes of violence, seeks to recognize from the narrative approach and the contextualized view of the conflict, the different affectations, traumas and restorative processes in populations that are victims of the armed conflict in Colombia. In order to fulfill this objective, a series of activities described in this paper were carried out; the photo voice experience applied in the departments of Atlántico, Magdalena, Bolívar and Antioquia; the analysis of the stories Carlos Arturo and Peñas Coloradas, where the psychosocial impacts, voices and meanings are contextualized in relation to the dominant image of violence, resilient and coping positions in the face of traumatic experiences in the victims; A series of analytical reports of the stories are described, circular, strategic and reflective questions of the Carlos Arturo story, and the design of psychosocial strategies for the strengthening of the Peñas Coloradas community is also evidenced. As a conclusion, the different perspectives and subjectivities immersed in the scenarios of violence are recognized, through the approach of cases and disciplinary tools of the diploma course; guiding the psychology student in the recognition of psychosocial accompaniment to victims of the conflict

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

¡Atención Poli, con la vista en el riesgo! cuentos para seguritos

El contar historias o el storytelling, aparece como una herramienta para autores que no solo buscan el conectar de forma más auténtica con sus lectores; sino que buscan ir más allá al comprender cómo el cerebro procesa esta poderosa forma de comunicación. (Suzuki, W., Feliú-Mójer, M., Hasson, U., Yehuda, R., & Zarate, J. 2018). Esta nueva forma de contar algo, es presentada aquí, en la primera compilación de cuentos como resultado de trabajos de módulos que tratan sobre el cuerpo humano, donde el estudio y la comprensión de la forma cómo funciona nuestro organismo, es uno de los principales objetivos. Además, surge como estrategia pedagógica, que precisamente busca incentivar el desarrollo de la creatividad de los estudiantes dentro de módulos que contienen un importante abordaje de temas y conceptos como base para su desarrollo, módulos que, al incluir un alto contenido teórico, se presentan como retos para que sus temas sean interiorizados por los estudiantes. De este modo, cuando se acude a el uso de la creatividad a través del storytelling, donde se expresan ideas relacionadas con el cuerpo humano, los cuentos realizados por estudiantes aquí presentes logran mostrar cómo emplean dichos conocimientos adquiridos, organizan ideas y crean cuentos que permiten al lector recrease, conociendo diferentes aspectos sobre nuestro cuerpo y a su vez dejándose llevar por la imaginación de los autores

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies

Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries

Ensayos sobre aplicación de la Teoría del Estado en las algunas culturas del Perú antiguo

Investigations of State Theory on the cultures of ancient Peru.Capítulos de libro con investigaciones de Teoría del Estado sobre las culturas del Perú antiguo, realizado por docentes y estudiantes de la Escuela Profesional de Derecho de la Universidad Nacional del Altiplano de Puno.      

Ensayos sobre aplicación de la Teoría del Estado en las algunas culturas del Perú antiguo

Investigations of State Theory on the cultures of ancient Peru.Capítulos de libro con investigaciones de Teoría del Estado sobre las culturas del Perú antiguo, realizado por docentes y estudiantes de la Escuela Profesional de Derecho de la Universidad Nacional del Altiplano de Puno.      

Ensayos sobre aplicación de la Teoría del Estado en las algunas culturas del Perú antiguo

Investigations of State Theory on the cultures of ancient Peru.Capítulos de libro con investigaciones de Teoría del Estado sobre las culturas del Perú antiguo, realizado por docentes y estudiantes de la Escuela Profesional de Derecho de la Universidad Nacional del Altiplano de Puno.      

Ensayos sobre aplicación de la Teoría del Estado en las algunas culturas del Perú antiguo

Investigations of State Theory on the cultures of ancient Peru.Capítulos de libro con investigaciones de Teoría del Estado sobre las culturas del Perú antiguo, realizado por docentes y estudiantes de la Escuela Profesional de Derecho de la Universidad Nacional del Altiplano de Puno.      

Ensayos sobre aplicación de la Teoría del Estado en las algunas culturas del Perú antiguo

Investigations of State Theory on the cultures of ancient Peru.Capítulos de libro con investigaciones de Teoría del Estado sobre las culturas del Perú antiguo, realizado por docentes y estudiantes de la Escuela Profesional de Derecho de la Universidad Nacional del Altiplano de Puno.