La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Municipios de Gachalá, Junín, Chía-Cota, Ibagué, Nilo

El conflicto armado es un problema de impacto en Colombia ya que los más afectados en esta situación son los niños, niñas, adultos, ancianos, no importan su género, religión, raza, este grupo de personas son atropellados en varios derechos como el respeto, la igualdad, la dignidad, a la vida, entre otras. Estas poblaciones son olvidadas por el gobierno, de igual manera son personas que son afectadas psicológica, social, emocional, y físicamente, por eso la importancia de trabajar con este grupo de población, es crear estrategias para minimizar riesgo traumático y emocionales. El conflicto armado nen nuestro país, data de muchos años atrás, y surge por diferencias entre partidos políticos y la noción de injusticias sociales, sobre todo en la repartición de la tierra (entendida este como un factor de producción y riqueza) y la carencia de espacios destinados a la participación ciudadana. Durante todos estos años (más de 50 décadas), han ido surgiendo nuevos actores, producto de un cambio de pensamiento y una necesidad de poder y control, no solo monetario, sino de territorito, y así es precisamente como se involucran al conflicto los narcotraficantes, quienes en su lucha por ganar territorios, han provocado un sin numero de desplazamiento y han sembrado terror y miedo en muchas poblaciones, aprovechando un poco el desinterés del estado en estos territorios y su localización, que por lo general es de difícil acceso. (Ribera, 2008) Las poblaciones que habitan en estos territorios disputados por los actores armados, son quienes deben vivir el conflicto día a día, pues se les limita sus participaciones, pensamientos y hasta acciones; allí en esta población se hace realmente lo que estos grupos ordenen, dejando atrás el concepto de estado social de derecho, enmarcado en la constitución política de Colombia. Sus pobladores muchas veces cansados de la situación, abandonan todo, buscando una vida propia; y es donde se produce el desplazamiento. Sin embargo, el daño ya se encuentra en esta población desplazada, ellos deben luchar por sanar sus heridas, tanto físicas como emocionales y mentales; y es allí donde se propone una intervención psicosocial. La intervención psicosocial propone como objetivo buscar acciones psicosociales para mejorar la salud mental de este tipo de población. Como primer paso a esta intervención psicosocial, se propone en el presente documento un diagnostico social desde la narrativa como instrumento principal, buscando que las victimas afronten la situación y acepten los sucesos vividos, evitando una negación y rechazo de sus experiencias, para lo cual se aplica el enfoque narrativo, en donde mediante el relato de Peñas Coloradas, se plantean una serie de estrategias psicosociales, identificando las acciones a implementar y el impacto que se busca generar en los actores involucrados.The armed conflict is a problem of impact in Colombia since the most affected in this situation are children, adults, the elderly, no matter their gender, religion, race, this group of people are trampled on various rights such as respect, equality, dignity, life, among others. These populations are forgotten by the government, in the same way they are people who are affected psychologically, socially, emotionally, and physically, so the importance of working with this population group is to create strategies to minimize traumatic and emotional risk. The armed conflict in our country dates back many years, and arises from differences between political parties and the notion of social injustices, especially in the distribution of land (understood as a factor of production and wealth) and the lack of spaces for citizen participation. During all these years (more than 50 decades), new actors have emerged, as a result of a change of thought and a need for power and control, not only monetary, but also territorial, and that is precisely how drug traffickers get involved in the conflict. , who in their struggle to gain territories, have caused countless displacement and have sown terror and fear in many populations, taking a little advantage of the state's disinterest in these territories and their location, which is generally difficult to access. (Ribera, 2008) The populations that inhabit these territories disputed by the armed actors are the ones who must live the conflict day by day, since their participation, thoughts and even actions are limited; There, in this population, what these groups order is really done, leaving behind the concept of the social state of law, framed in the political constitution of Colombia. Its inhabitants, who are often tired of the situation, abandon everything, looking for a life of their own; and is where the displacement occurs. However, the damage is already in this displaced population, they must fight to heal their wounds, both physical, emotional and mental; and it is there where a psychosocial intervention is proposed. The psychosocial intervention proposes the objective of seeking psychosocial actions to improve the mental health of this type of population. As a first step to this psychosocial intervention, a social diagnosis from the narrative is proposed in this document as the main instrument, seeking that the victims face the situation and accept the events experienced, avoiding a denial and rejection of their experiences, for which applies the narrative approach, where through the story of “Peñas Coloradas”, a series of psychosocial strategies are proposed, identifying the actions to be implemented and the impact that it seeks to generate on the actors involved

The feasibility of establishing parent support groups for children with congenital Zika syndrome and their families: a mixed-methods study

Background: The Zika epidemic highlighted gaps in health and social care services for parents of children with developmental disabilities. We aimed to evaluate the feasibility of a 10-week support group, ‘Juntos’, as a community-based intervention for parents of children with congenital Zika syndrome (CZS) in Colombia. Methods: Two facilitators delivered ‘Juntos’ to four groups of 8-10 caregivers. One researcher observed each group. Data were collected from: observation notes from 40 sessions, focus group discussions held after each session, pre- post intervention questionnaires with 34 caregivers, and semi-structured interviews conducted with four facilitators, 12 caregivers and three stakeholders. We used the Bowen framework in data analysis. Results: Acceptability and demand for the intervention were high. ‘Juntos’ was largely delivered with fidelity. Practicality was facilitated by providing transport costs and selecting convenient locations. Adaption requirements included additional organisational and social media support. Community health worker training may support integration and the established groups could facilitate programme expansion; however, participants perceived lack of prioritisation as a limitation. Participants’ knowledge and confidence to care for their child improved after programme enrolment. Conclusion: Acceptability, demand and practicality of ‘Juntos’ is high. Yet implementation is challenged by existing health systems gaps in support of children with CZS

Temas Socio-Jurídicos. Volumen 30 No. 62 Junio 2012

La Revista Temas Socio Jurídicos es una publicación seriada del Centro de Investigaciones Socio Jurídicas, dependencia adscrita a la Facultad de Derecho de la Universidad Autónoma de Bucaramanga, que se dirige principalmente a Abogados, profesionales de las ciencias sociales y humanas, a estudiantes de derecho y de ciencias sociales y humanas.The Socio Legal Issues Magazine is a serial publication of the Socio Legal Research Center, a dependency attached to the Faculty of Law of the Autonomous University of Bucaramanga, which is aimed mainly at Lawyers, professionals in the social and human sciences, law students and social and human sciences

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Prevalence and factors related with the presence of oral manifestations in HIV/AIDS patients who attended health institutions in Cali, Colombia

Objetivo: Determinar la prevalencia y factores relacionados con la presencia de manifestaciones orales en pacientes VIH/ SIDA que asistieron a instituciones prestadoras de salud en Cali, Colombia. Materiales y métodos: Se realizó un estudio descriptivo transversal que incluyó 319 pacientes que asistían a 4 instituciones prestadoras de salud en Cali. Los criterios de inclusión fueron ser paciente VIH confirmado, mayor de 18 años, asistir a control médico y tener voluntad de participar. Se excluyeron mujeres embarazadas y reclusos. Resultados: La prevalencia general de manifestaciones orales fue 77.1% (IC 95%: 72.4-81.7). La más frecuente fue la xerostomía con 41.1% (IC 95%: 35.5-46.6), seguida por las manifestaciones de origen micótico [(35.7% (IC 95% 30.4-41)] bacteriano [34.2% (IC 95%: 28.9-39.4)] virales [16.6% (IC 95% 12.5.20.7)], úlceras orales [(7.5 (IC 95%: 4.6-10.4)] y neoplásicas [3.8 (IC 95% 1.6-5.8)]. No se presentó linfoma no Hodgkin. En el análisis multivariado, la presencia de lesiones orales se asoció con un tiempo diagnóstico de la enfermedad menor a 12 meses, carga viral detectable, presencia de prótesis dental removible y el auto-informe de boca reseca. Conclusión: La prevalencia de manifestaciones orales registrada en esta población es alta comparada con las informadas a nivel mundial. Teniendo en cuenta las asociaciones encontradas, se puede sugerir que las lesiones orales son características clínicas iniciales de la enfermedad y son predictores de progresión de VIH a SIDA y falla de tratamiento. Aim: To determine the prevalence and factors related with the presence of oral manifestations in HIV/AIDS patients who attended health institutions in Cali-Colombia. Materials and methods: A cross-sectional descriptive study was made in 319 patients who attended four health institutions in the city of Cali. The inclusion criteria were: being HIV positive patients, being over 18 years old, attending medical checkups and accepting participation. Pregnant women and inmates were excluded. Results: The general prevalence of oral manifestations was 77.1% (CI 95%: 72.4-81.7). The most frequent oral manifestation was xerostomia with 41.1% (CI 95%: 35.5-46.6), followed by the manifestations from mycotic origin [(35.7% (CI 95% 30.4-41)] bacterial [34.2% (CI 95%: 28.9-39.4)] virals [16.6 (CI 95% 12.5-20.7)], oral ulcers [7.5 (CI 95%: 4.6- 10.4)] and neoplastics [3.8 (CI95% 1.6-5.8)]. The population studied did not show non-Hodgkin’s lymphoma. In the multivariate analysis, the presence of oral injuries was associated with time of HIV/AIDS diagnosis during the previous 12 months, detectable viral load, and presence of removable dental prosthesis and self-report of dry mouth. Conclusions: The prevalence of oral manifestations registered in this population is high compared with those reported world-wide. Considering the association found, our results suggest that oral injuries are initial clinic characteristics of the disease and may be useful to predict treatment failure and progression from HIV infection to AIDS

Data collection tools for a study on establishing the feasibility of parent support groups for children with Congenital Zika Syndrome and their families in Colombia

A set of research tools used to collect information from participants, facilitators and stakeholders of 4 pilot parent support groups for children with Congenital Zika Syndrome, in Valle del Cauca, Colombia. It includes questionnaires for participants and topic guides for semi-structured interviews with participants, facilitators and stakeholders

The feasibility of establishing parent support groups for children with congenital Zika syndrome and their families: a mixed-methods study [version 3; peer review: 2 approved]

Background: The 2015 – 2016 Zika epidemic highlighted gaps in health and social care services for parents of children with developmental disabilities. In response, we developed the ‘Juntos’ intervention, a 10 week community-based early intervention support group for parents of children with congenital Zika syndrome (CZS). The intervention's components include participatory learning sessions, practical skill acquisition, peer support, and psychological support, aiming to improve caregiver’s knowledge and confidence in caring for their children. This study aimed to evaluate the feasibility of implementing ‘Juntos’ in Colombia. Methods: Two facilitators delivered ‘Juntos’ to four groups of 8-10 caregivers between 2017 and 2018. One researcher observed each group. Data were collected from: observation notes from 40 sessions, focus group discussions held after each session, pre- post intervention questionnaires with 34 caregivers, and semi-structured interviews conducted with four facilitators, 12 caregivers and three stakeholders. We used the Bowen framework in data analysis. Results: The feasibility evaluation revealed that 'Juntos' was highly acceptable and in demand among the target population. The intervention was predominantly delivered with fidelity. Practicality was facilitated by providing transport costs and selecting convenient locations. Additional organisational and social media support was required for successful implementation. Community health worker training may support integration and the established groups could facilitate programme expansion. However, participants perceived lack of prioritisation as a limitation within existing health systems. Participants’ knowledge and confidence to care for their child improved after programme enrolment. Conclusion: The 'Juntos' intervention demonstrated high acceptability, demand, and practicality in supporting parents of children with CZS in Colombia. However, its implementation faces challenges due to existing gaps in health system support for children with CZS

Prevalencia y Factores Relacionados Con la Presencia de Manifestaciones Orales en Pacientes Con VIH/SIDA, Cali, Colombia

Aim: To determine the prevalence and factors related with the presence of oral manifestations in HIV/AIDS patients who attended health institutions in Cali-Colombia. Materials and methods: A cross-sectional descriptive study was made in 319 patients who attended four health institutions in the city of Cali. The inclusion criteria were: being HIV positive patients, being over 18 years old, attending medical checkups and accepting participation. Pregnant women and inmates were excluded. Results: The general prevalence of oral manifestations was 77.1% (CI 95%: 72.4-81.7). The most frequent oral manifestation was xerostomia with 41.1% (CI 95%: 35.5-46.6), followed by the manifestations from mycotic origin [(35.7% (CI 95% 30.4-41)] bacterial [34.2% (CI 95%: 28.9-39.4)] virals [16.6 (CI 95% 12.5-20.7)], oral ulcers [7.5 (CI 95%: 4.6-10.4)] and neoplastics [3.8 (CI95% 1.6-5.8)]. The population studied did not show non-Hodgkin's lymphoma. In the multivariate analysis, the presence of oral injuries was associated with time of HIV/AIDS diagnosis during the previous 12 months, detectable viral load, and presence of removable dental prosthesis and self-report of dry mouth. Conclusions: The prevalence of oral manifestations registered in this population is high compared with those reported world-wide. Considering the association found, our results suggest that oral injuries are initial clinic characteristics of the disease and may be useful to predict treatment failure and progression from HIV infection to AIDS.Objetivo: Determinar la prevalencia y factores relacionados con la presencia de manifestaciones orales en pacientes VIH/SIDA que asistieron a instituciones prestadoras de salud en Cali, Colombia. Materiales y métodos: Se realizó un estudio descriptivo transversal que incluyó 319 pacientes que asistían a 4 instituciones prestadoras de salud en Cali. Los criterios de inclusión fueron ser paciente VIH confirmado, mayor de 18 años, asistir a control médico y tener voluntad de participar. Se excluyeron mujeres embarazadas y reclusos. Resultados: La prevalencia general de manifestaciones orales fue 77.1% (IC 95%: 72.4-81.7). La más frecuente fue la xerostomía con 41.1% (IC 95%: 35.5-46.6), seguida por las manifestaciones de origen micótico [(35.7% (IC 95% 30.4-41)] bacteriano [34.2% (IC 95%: 28.9-39.4)] virales [16.6% (IC 95% 12.5.20.7)], úlceras orales [(7.5 (IC 95%: 4.6-10.4)] y neoplásicas [3.8 (IC 95% 1.6-5.8)]. No se presentó linfoma no Hodgkin. En el análisis multivariado, la presencia de lesiones orales se asoció con un tiempo diagnóstico de la enfermedad menor a 12 meses, carga viral detectable, presencia de prótesis dental removible y el auto-informe de boca reseca. Conclusión: La prevalencia de manifestaciones orales registrada en esta población es alta comparada con las informadas a nivel mundial. Teniendo en cuenta las asociaciones encontradas, se puede sugerir que las lesiones orales son características clínicas iniciales de la enfermedad y son predictores de progresión de VIH a SIDA y falla de tratamiento

Manejo clínico de pacientes menores de 5 años hospitalizados con diagnóstico de neumonía acorde con la estrategia AIEPI, en una institución de salud, Cauca, Colombia

Acute respiratory infections represent one of the major public health problems in children under 5 year of age. Generating between 50 and 70% of all queries, and between 30% and 60% of all hospitalizations. The Integrated Management of Childhood Illness (IMCI) is a validated worldwide tool adopted now in Colombia that advances in response and solution to the problems in this population. This research evaluates the attention of hospitalized children under 5 year of age with a pneumonia diagnosis in an institution of level II, for which a descriptive study was developed through a review of 58 medical records. As results nonadherence to IMCI guide specifically on the classification of the disease, evidence antibiotic used inside and outside the hospital, the doses used and the recommendations given to the caregivers. This establishes the need to continue working on this issue to allow the infant morbidity and mortality impact and reduce the number of hospitalizations, complications, and thus the cost of care.Las infecciones respiratorias agudas representan uno de los principales problemas de salud pública en menores de 5 años, que genera entre el 50% y 70% de todas las consultas, y entre 30% y 60% de todas las hospitalizaciones. La estrategia Atención Integral para las Enfermedades Prevalentes de la Infancia (AIEPI) es una herramienta validada a nivel mundial y adoptada en Colombia que permite avanzar en la respuesta y solución a los problemas en esta población. En un estudio observacional descriptivo a través de la revisión de 58 historias clínicas, se evaluó la atención de los menores de 5 años, hospitalizados en una institución de nivel II con diagnóstico de neumonía. Como resultados se evidencia la no adherencia a la guía AIEPI, específicamente en la clasificación de la enfermedad, el antibiótico utilizado intra y extrahospitalariamente, las dosis utilizadas y las recomendaciones impartidas a los cuidadores. Lo anterior establece la necesidad de seguir trabajando en esta problemática que permita impactar la morbimortalidad infantil, así como disminuir el número de hospitalizaciones, complicaciones, y por ende el costo en la atenció

Atitude dos estudantes em três faculdades de odontologia em Santiago de Cali, Colômbia, frente a pacientes com HIV

Objective: To know attitude of students at three dental schools in Santiago de Cali, Colombia, toward HIV+ patients. Methods: This is a cross-sectional study with using a questionnaire to 1173 invited to attend students from three dental schools in Cali. Students were classified in three groups (Pre-clinic: semester I-IV; initial clinic: V to VII and last clinical: VIII to X). Results: Participation rate was 63.4%. 50% under 20 years old, 68% female, 92% single, and 82% Catholics. Between 86% and 92% had positive attitudes; when asked about their willingness to care patients being more favorable preclinical students (p=0.03). Although, 88.7% of all students showed a willingness to address HIV patients. Among those who believed that it would be difficult for assistant staff to accept treating such patients there was a 33% chance of doing so (p=0.003). When we asked about training to manage, between 67% (clinical) and 82% (preclinical) perceive not receiving any. Conclusions: The intention to dental care was similar to that reported in the other American countries, and Ireland. Dental students need better training, because they do not perceived adequate training, to reduce their fear and increase posi- tive attitudes to care for HIV/AIDS patients. Objetivos: Conocer la actitud de estudiantes de odontología de Cali respecto del manejo de personas con diagnóstico de VIH/SIDA. Método: Estudio observacional descriptivo mediante aplicación de una encuesta aplicada en 1.173 estudiantes de tres facultades de odontología de Cali, clasificados en tres grupos (preclínica, clínica inicial y clínica final). Resultados: participó un 63,4%; 50% tenía menos de 20 años, 68% mujeres. 92% solteros y 82% católicos. Se encontró actitud positiva entre 86% y 92%, la disposición de atender pacientes fue más favorable en preclínica (p=0.03). Aunque 88,7% mostró disposición de atender pacientes VIH+; entre los que pensaban que sería difícil hacerlo para su personal auxiliar, se encontró 33% de estudiantes con probabilidad de hacerlo, (p= 0.03). Cuando se interrogó sobre conocimientos acerca del VIH/SIDA, 66,7% (clínica final) y 82,2% (preclínica) percibían que no habían recibido entrenamiento previo (pObjetivos: Conhecer a atitude de estudantes de odontologia de Cali a respeito do manejo de pessoas com diagnóstico de HIV/AIDS. Método: Estudo observacional descritivo mediante aplicação de um questionário aplicado em 1.173 estudantes de três faculdades de odontologia de Cali, classificados em três grupos (pré-clínica, clínica inicial e clínica final). Resultados: participaram 63,4%; 50% tinham menos de 20 anos, 68% mulheres. 92% solteiros e 82% católicos. Foi encontrada atitude positiva entre 86% e 92%; a disposição de atender pacientes foi mais favorável na pré-clínica (p=0.03). Ainda que 88,7% mostraram disposição de atender pacientes HIV+; entre os que pensavam que sería difícil fazê-lo para o seu pessoal auxiliar, foram encontrados 33% de estudantes com probabilidade de fazê-lo, (p= 0.03). Quando se interrogou a cerca de conhecimentos sobre HIV/AIDS, 66,7% (clínica final) e 82,2% (pré-clínica) perceberam que não haviam rece- bido treinamento prévio (