La vega, colombia: healthy municipality. a case study

In 1992 Colombia adopted the strategy of healthy municipalities, renamed in 1997 as healthy municipalities for peace. This strategy was promoted from different sectors and directed to social mobilization aimed at locally achieving equity, quality of life, and social development, thus allowing the creation of favorable-for-peace environments. Some municipalities have applied this strategy and both its processes as well as its results must be studied in order to learn from this experience. One of these municipalities was La Vega in the department of Cundinamarca. A case study of this municipality was carried out in order to evaluate some of the components of this strategy such as political involvement, healthy public policies, articulation between sectors and the organizational structure supporting this strategy. In this municipality the process began in 1990 as a primary health care strategy. In 1992 the mayor declared his commitment to this strategy and a plan of participative development, aimed at improving the quality of life of its population, was implemented. In this same year the Colombian Ministry of Health and the Pan American Health Organization recognized it as a healthy municipality and in 1997 it obtained the national healthy municipality prize. The relevant aspect of La Vega has been the process of community participation, basis of the work aimed at improving peoples´ health.La estrategia de Municipios Saludables se adoptó en Colombia en 1992 y en 1997 tomó el nombre de Municipio Saludable por la Paz. Se interpretó como una estrategia dirigida a la movilización social, impulsada desde diversos sectores para lograr la equidad, calidad de vida y desarrollo social en lo local, permitiendo la creación de ambientes propicios para la paz. Algunos municipios han aplicado esta estrategia y tanto sus procesos como resultados deben ser estudiados para aprender de su experiencia. Uno de estos municipios ha sido La Vega, ubicado en el Departamento de Cundinamarca, Colombia. Se llevó a cabo un estudio de caso de este municipio para evaluar algunos de los componentes de esta estrategia como el compromiso político, las políticas públicas saludables, la articulación intersectorial y la estructura organizativa que le sirve de soporte. El proceso en este municipio se inició en 1990, como una estrategia de atención primaria. En 1992 el alcalde municipal declaró su compromiso con la estrategia y se puso en práctica un plan de desarrollo participativo dirigido a mejorar la calidad de vida de su población. En ese mismo año el Ministerio de Salud y la Organización Panamericana de la Salud lo reconocieron como Municipio Saludable y en 1997 obtuvo el premio nacional de municipio saludable. Lo relevante de La Vega ha sido el proceso de participación comunitaria, eje del trabajo por mejorar la salud de la población

Better Together: Improving Food Security and Nutrition by Linking Market and Food Systems

Market-based approaches to food security often increase agricultural productivity and income yet sometimes fail to enhance nutrition. When food security programming combines market and food systems with a specific focus on women and girls, economic and nutrition outcomes benefit. We identify distinctive and shared elements from market and food systems and highlight how they enhance nutrition outcomes when they are combined. We describe food security programming by CARE and World Vision in Bangladesh, Ethiopia, Madagascar, Zambia, and Zimbabwe, demonstrating nutrition gains in food insecure households

Diagnosis, Prognosis, and Therapy of Transthyretin Amyloidosis

AbstractTransthyretin amyloidosis is a fatal disorder that is characterized primarily by progressive neuropathy and cardiomyopathy. It occurs in both a mutant form (with autosomal dominant inheritance) and a wild-type form (with predominant cardiac involvement). This article guides clinicians as to when the disease should be suspected, describes the appropriate diagnostic evaluation for those with known or suspected amyloidosis, and reviews the interventions currently available for affected patients

Evaluating the efficacy of commercially available aflatoxin binders for decreasing the effects of aflatoxicosis on Pacific white shrimp Litopenaeus vannamei

Feeding aflatoxin-contaminated diets to shrimp juveniles reduces feed intake and growth rate, suppresses the immune system, causes hepatic lesions, and, in some cases, decreases survival rates. There is scarce information on the effectiveness of commercially available aflatoxin binders to reduce aflatoxicosis in shrimp. Goals. We investigated the effect of corn that was naturally contaminated with aflatoxins on the growth performance and nitrogen retention efficiency of white shrimp juveniles L. vannamei and the potential of three commercially available anti-aflatoxin additives. Methods. 20 tanks (60L) were stocked with 10 shrimp weighing 210±4mg. Tanks were divided into five treatments with four replicates each. Shrimp were fed twice daily with either the contaminated diet (75 ?g kg1 total aflatoxins), the contaminated diet supplemented with 2 g kg-1 Aflabalan®, 2 g kg-1 Mycosorb®, and 2.5 g kg-1 Mycoflix plus®, or the uncontaminated diet to the control group for 42 days. Results. In terms of the diet containing aflatoxin without binding agents, the consumption, growth rate, and nitrogen-retention efficiency were significantly lower than the control treatment. The experimental diets did not affect the feed conversion ratio or survival rates in any treatment. The inclusion of any of the aflatoxin binders evaluated in the present study did not produce growth rates comparable to those of shrimp fed the uncontaminated diet. Conclusions. Aflatoxins decreased growth performance in a population of white shrimp juveniles L. vannamei. Although all the aflatoxin binders evaluated in this study caused an improvement, they were not effective in reversing all the negative effects caused by feeding aflatoxin-contaminated diets to white shrimp juveniles L. vannamei

Arterial line pressure control enhanced extracorporeal blood flow prescription in hemodialysis patients

<p>Abstract</p> <p>Background</p> <p>In hemodialysis, extracorporeal blood flow (Qb) recommendation is 300–500 mL/min. To achieve the best Qb, we based our prescription on dynamic arterial line pressure (DALP).</p> <p>Methods</p> <p>This prospective study included 72 patients with catheter Group 1 (G1), 1877 treatments and 35 arterio-venous (AV) fistulae Group 2 (G2), 1868 treatments. The dialysis staff was trained to prescribe Qb sufficient to obtain DALP between -200 to -250 mmHg. We measured ionic clearance (IK: mL/min), access recirculation, DALP (mmHg) and Qb (mL/min). Six prescription zones were identified: from an optimal A zone (Qb > 400, DALP -200 to -250) to zones with lower Qb E (Qb < 300, DALP -200 to -250) and F (Qb < 300, DALP > -199).</p> <p>Results</p> <p>Treatments distribution in A was 695 (37%) in G1 vs. 704 (37.7%) in G2 (<it>P </it>= 0.7). In B 150 (8%) in G1 vs. 458 (24.5%) in G2 (<it>P </it>< 0.0001). Recirculation in A was 10.0% (Inter quartile rank, IQR 6.5, 14.2) in G1 vs. 9.8% (IQR 7.5, 14.1) in G2 (<it>P </it>= 0.62). IK in A was 214 ± 34 (G1) vs. 213 ± 35 (G2) (<it>P </it>= 0.65). IK Anova between G2 zones was: A vs. C and D (<it>P </it>< 0.000001). Staff prescription adherence was 81.3% (G1) vs. 84.1% (G2) (<it>P </it>= 0.02).</p> <p>Conclusion</p> <p>In conclusion, an optimal Qb can de prescribed with DALP of -200 mmHg. Staff adherence to DLAP treatment prescription could be reached up to 81.3% in catheters and 84.1% in AV fistulae.</p

Genotype and Phenotype of Transthyretin Cardiac Amyloidosis: THAOS (Transthyretin Amyloid Outcome Survey)

Background Transthyretin amyloidosis (ATTR) is a heterogeneous disorder with multiorgan involvement and a genetic or nongenetic basis. Objectives The goal of this study was to describe ATTR in the United States by using data from the THAOS (Transthyretin Amyloidosis Outcomes Survey) registry. Methods Demographic, clinical, and genetic features of patients enrolled in the THAOS registry in the United States (n&nbsp;= 390) were compared with data from patients from other regions of the world (ROW) (n&nbsp;= 2,140). The focus was on the phenotypic expression and survival in the majority of U.S. subjects with valine-to-isoleucine substitution at position 122 (Val122Ile) (n&nbsp;= 91) and wild-type ATTR (n&nbsp;= 189). Results U.S. subjects are older (70 vs. 46 years), more often male (85.4% vs. 50.6%), and more often of African descent (25.4% vs. 0.5%) than the ROW. A significantly higher percentage of U.S. patients with ATTR amyloid seen at cardiology sites had wild-type disease than the ROW (50.5% vs. 26.2%). In the United States, 34 different mutations (n&nbsp;= 201) have been reported, with the most common being Val122Ile (n&nbsp;= 91; 45.3%) and Thr60Ala (n&nbsp;= 41; 20.4%). Overall, 91 (85%) of 107 patients with Val122Ile were from the United States, where Val122Ile subjects were younger and more often female and black than patients with wild-type disease, and had similar cardiac phenotype but a greater burden of neurologic symptoms (pain, numbness, tingling, and walking disability) and worse quality of life. Advancing age and lower mean arterial pressure, but not the presence of a transthyretin mutation, were independently associated with higher mortality from a multivariate analysis of survival. Conclusions In the THAOS registry, ATTR in the United States is overwhelmingly a disorder of older adult male subjects with a cardiac-predominant phenotype. Val122Ile is the most common transthyretin mutation, and neurologic phenotypic expression differs between wild-type disease and Val122Ile, but survival from enrollment in THAOS does not. (Transthyretin-Associated Amyloidoses Outcome Survey [THAOS]; NCT00628745

Seroprevalence and Risk Factors Possibly Associated with Emerging Zoonotic Vaccinia Virus in a Farming Community, Colombia

In 2014, vaccinia virus (VACV) infections were identified among farmworkers in Caquetá Department, Colombia; additional cases were identified in Cundinamarca Department in 2015. VACV, an orthopoxvirus (OPXV) used in the smallpox vaccine, has caused sporadic bovine and human outbreaks in countries such as Brazil and India. In response to the emergence of this disease in Colombia, we surveyed and collected blood from 134 farmworkers and household members from 56 farms in Cundinamarca Department. We tested serum samples for OPXV antibodies and correlated risk factors with seropositivity by using multivariate analyses. Fifty-two percent of farmworkers had OPXV antibodies; this percentage decreased to 31% when we excluded persons who would have been eligible for smallpox vaccination. The major risk factors for seropositivity were municipality, age, smallpox vaccination scar, duration of time working on a farm, and animals having vaccinia-like lesions. This investigation provides evidence for possible emergence of VACV as a zoonosis in South America.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000318507https://scholar.google.com.co/citations?user=cU2KyT4AAAAJ&hl=enhttps://scienti.minciencias.gov.co/gruplac/jsp/visualiza/visualizagr.jsp?nro=00000000008981https://orcid.org/0000-0002-8093-054