La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia, Departamentos del Caquetá y Caldas

Colombia es una nación golpeada por el conflicto armado, esto ha generado diferentes impactos negativos y traumatismos impidiendo el normal desarrollo de la vida cotidiana del país, dentro de las diferentes regiones colombianas la población civil ha sido la más afectada, existe una gran diferencia social y esto genera que muchos colombianos estén ajenos a la problemática de la violencia, pero la realidad es que de manera directa o indirecta nos afecta a todos. Durante el avance de cada una de las actividades realizadas en el diplomado de profundización y acompañamiento psicosocial en escenarios de violencia realizamos el abordaje de diferentes temáticas como la foto voz que nos permitió mediante imágenes la narración de hechos e historias y casos que como psicólogos en formación nos sirvió para fortalecer nuestros conocimientos mediante un acercamiento real a la situación actual de nuestro país, donde a través de la narrativa como herramienta de abordaje psicosocial logramos comprender, profundizar e interpretar e identificar las diferentes experiencias vividas de la violencia relacionada con el conflicto armado y como estas han afectado emocional, social y psicológicamente a las víctimas. El presente trabajo tiene como finalidad exponer y presentar el desarrollo de habilidades y elaboración de estrategias de intervención para el abordaje psicosocial en escenarios de violencia tanto individual, familiar y comunitario acordes y adecuadas en colectividades afectadas por el conflicto armado, proporcionándoles a las víctimas mediante la narrativa y subjetividad que permita darle forma a su realidad para emprender un nuevo camino y proyecto de vida, específicamente trabajamos sobre el caso Modesto Pacayá un indígena reclutado a la fuerza por las FARC quien se desmovilizó y logro rehacer su vida junto con familia. A continuación, encontraran la elaboración de preguntas estratégicas, circulares y reflexivas diseñas por el grupo específicamente para el caso de Modesto Pacayá, preguntas que permitieron un acercamiento productivo con la víctima, también hallaran el trabajo de abordaje psicosocial en el Caso de Peñas para este elaboramos acciones y objetivos plantea (Mundial, 2009, pág. 78) das para la intervención del caso de Peñas Coloradas Ubicado en el del Caquetá que apuntan a una transformación.Colombia is a nation hit by the armed conflict, this has generated different negative impacts and trauma preventing the normal development of daily life in the country, within the different Colombian regions the civilian population has been the most affected, there is a great social difference and This causes many Colombians to be oblivious to the problem of violence, but the reality is that it directly or indirectly affects us all. During the progress of each one of the activities carried out in the diploma of psychosocial deepening and accompaniment in scenes of violence, we carried out the approach of different topics such as the photo voice that allowed us through images the narration of facts and stories and cases that as psychologists in training It served us to strengthen our knowledge through a real approach to the current situation in our country, where through narrative as a psychosocial approach tool we managed to understand, deepen and interpret and identify the different experiences of violence related to the armed conflict and how these have affected the victims emotionally, socially and psychologically. The purpose of this work is to present the development of skills and the elaboration of intervention strategies for the psychosocial approach in scenarios of both individual, family and community violence consistent and appropriate in communities affected by the armed conflict, providing the victims through narrative and subjectivity to give shape to their reality to undertake a new path and life project, specifically we work on the case of Modesto Pacayá, an Indigenous man recruited by force by the FARC who demobilized and managed to rebuild his life together with his family. Next, they will find the elaboration of strategic, circular and reflective questions designed by the group specifically for the case of Modesto Pacayá, questions that allowed a productive approach with the victim, they will also find the work of psychosocial approach in the Case of Peñas for this we elaborated Actions and objectives proposed for the intervention of the case of Peñas Coloradas located in Caquetá that point to a transformation

Arboviral Etiologies of Acute Febrile Illnesses in Western South America, 2000–2007

Over recent decades, the variety and quantity of diseases caused by viruses transmitted to humans by mosquitoes and other arthropods (also known as arboviruses) have increased around the world. One difficulty in studying these diseases is the fact that the symptoms are often non-descript, with patients reporting such symptoms as low-grade fever and headache. Our goal in this study was to use laboratory tests to determine the causes of such non-descript illnesses in sites in four countries in South America, focusing on arboviruses. We established a surveillance network in 13 locations in Ecuador, Peru, Bolivia, and Paraguay, where patient samples were collected and then sent to a central laboratory for testing. Between May 2000 and December 2007, blood serum samples were collected from more than 20,000 participants with fever, and recent arbovirus infection was detected for nearly one third of them. The most common viruses were dengue viruses (genera Flavivirus). We also detected infection by viruses from other genera, including Alphavirus and Orthobunyavirus. This data is important for understanding how such viruses might emerge as significant human pathogens

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Yearly incidence rates of arboviral diseases in Iquitos, Peru, per 100,000 residents.

<p>The first year (2000) is excluded as the study did not start until mid-way through the year.</p

Map of study sites in Ecuador, Peru, Bolivia, and Paraguay.

<p>Capitals of Ecuador (Quito), Peru (Lima), and Bolivia (La Paz) are shown for reference.</p

DENV serotypes circulating in western South America, 2000–2007.

<p>DENV serotypes circulation was analyzed based on different regions, including (A) Ecuador and northwestern Peru (Tumbes and Piura), (B) northeastern and central Peru (Iquitos, Yurimaguas, and La Merced), and (C) southeastern Peru (Puerto Maldonado) and Bolivia.</p

Febrile illness surveillance study sites.

1<p>Year site was added to the study.</p>2<p>Military (M), Public Hospital (H), Public Health Clinic (C), Private Hospital (P).</p

Association between arbovirus infection and demographic variables in Iquitos, Peru, 2000–2007.

<p>*p<0.05;</p><p>**p<0.001.</p><p>For the Total column, numbers in parentheses represent the distribution of each variable within the category. For each individual arbovirus the numbers in parentheses represent the percent of participants within each variable category that were positive for the selected arboviruses.</p