La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia. Departamento Risaralda, Valle y Caldas.

La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia. Departamento Risaralda, Valle y Caldas.Cada relato expuesto, es una radiografía de los diferentes tipos de violencia que se viven en Colombia por más de medio siglo, partiendo del análisis de las subjetividades inmersas en los contextos de violencia, representados en diferentes zonas del país y enmarcados en cada uno de los cinco relatos expuesto. Cada uno, nos muestran las consecuencias a nivel social, económico, político, cultural y personal, reflejado en los protagonistas que describen en sus historias, a través de su propia narrativa, cómo han sido las consecuencias reflejadas en el abuso, el desplazamiento, el secuestro, la violación a los derechos humanos, la inseguridad, la pobreza, el narcotráfico, el desempleo y el desarraigo de su comunidad. Como eje del análisis grupal, se seleccionó el relato N. 2 “Camilo”, enmarcado en la violencia que se ha ensañado contra los jóvenes del país, reflejada en sucesos que van desencadenando hechos de violencia, donde se ve reflejada la injusticia y la desigualdad como denominador de las circunstancias que se expone en su narrativa. Se puede resaltar: la discriminación racial, su condición de desplazado, su desarraigo de identidad, así como su posición resiliente la cual permite hacer procesos de aceptación y de superación de cada una de las adversidades que ha vivido, enfrentando nuevos retos que lo han fortalecido en su proceso formativo y su capacidad de empoderamiento para crecer como individuo y generar nuevas oportunidades de vida. Es importante analizar los factores psicosociales que lo han afectado como sobreviviente de la violencia y lo han marcado, como también poder superar las dificultades y a partir de un proyecto de vida como este, puede contribuir desde su experiencia a su comunidad. A partir del estudio relacionado con la incursión dada en la cuenca del Cacarica, se presentan varias propuestas de intervención psicosocial para contribuir a mejorar las condiciones y la transformación de los hechos violentos que se presentaron contra la población civil y de esta forma promover la reconstrucción de la memoria histórica y hacer parte del proceso de reparación del tejido social de la comunidad.Each exposed story is an x-ray of the different types of violence that have been lived in Colombia for more than half century, based on the analysis of subjectivities immersed in the contexts of violence, represented in different regions of the country and framed in each of the five stories exposed. Each one shows us the consequences at the social, economic, political, cultural and personal level, reflected in the protagonists they describe in their stories, through their own narrative, how the consequences have been reflected in abuse, displacement, kidnapping, violence against human rights, insecurity, poverty, drug trafficking, unemployment and uprooting from their community. As the focus of the group analysis, we select the story N. 2 “Camilo”, framed in the violence that has been taught against the youth of the country, reflected in events that are triggering acts of violence, where injustice and inequality are reflected as denominator of the circumstances that exposes us in his narrative. We can highlight: racial discrimination, his condition as a homeless person, his uprooting identity, as well as his resilient position which allows the acceptance and overcoming of each one of the adversities he has lived through, facing new challenges that have strengthened him in its formative process and its empowerment capacity to grow as an individual and generate new life opportunities. It is important to analyze the psychosocial factors that have affected him as a survivor of violence and have marked him, as well as being able to overcome difficulties and from a life project like this, he can contribute from his experience to his community. From the study related to the incursion in the Cacarica basin, several proposals for psychosocial intervention are presented to help improve the conditions and transformation of the violent events that were filed against the civilian population and thus promote the reconstruction of the historical memory of the community and take part of the social repairing process of the community

Common variants in Alzheimer's disease and risk stratification by polygenic risk scores.

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Nat Commun

Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease