Factors associated with suicidal behavior in adolescents from Bogotá who are enrolled in grades 9-11 in educational institutions

Introducción: En los últimos años, se ha observado un aumento del intento suicida entre la población joven, sin embargo, no es posible explicar específicamente este fenómeno; las tasas más altas de suicidio en nuestro país se encuentran en los grupos etarios correspondientes a 15-24 años, siendo esta una conducta evitable es necesario conocer el comportamiento y las características de esta problemática en nuestro territorio. Objetivo: Determinar la prevalencia de conducta suicida y describir los factores asociados en adolescentes de 9 a 11 grado de instituciones educativas de la ciudad de Bogotá D.C. Método: Estudio transversal analítico; se aplicó un cuestionario autoaplicado para determinar la prevalencia y características de la conducta suicida, en una muestra no probabilística de estudiantes de 9, 10 y 11 grado en Bogotá. Se realizó análisis bivariado de las variables en la población estudiada. Resultados: Se aplicaron 459 encuestas a estudiantes entre 9 a 11 grado en 6 instituciones públicas de Bogotá, el 41% presento ideación suicida alguna vez en su vida, y el 20,7% de los adolescentes cometieron alguna vez un intento suicida. Las variables asociadas más frecuentes en la población con intento suicida fueron: sexo femenino OR=2,36 (1,49-3,76), bisexualidad OR 4,64 (1,83-11,77), percepción de disfunción escolar OR 2,41(1,31-4,44), depresión OR= 6,32 (3,46-11,55), intento suicida familiar OR= 5,33 (3,28, 8,65), antecedentes psiquiátricos personales OR= 4,19 (2,38-7,40) y familiares OR= 2,68 (1,61-4,46). Conclusiones: Las características más sobresalientes fueron similares a las reportadas en la literatura científica, siendo la depresión y familiar con intento suicida previo los mas representativos. Se encontró una prevalencia mayor a la esperada para este grupo etario, hallazgo que podría explicarse porque un gran número de casos de suicidio no consumado no consultan en el sistema de salud.1. PLANTEAMIENTO DEL PROBLEMA Y JUSTIFICACIÓN 15 1.1 PREGUNTA DE INVESTIGACIÓN 16 2. OBJETIVOS 17 2.1 OBJETIVO GENERAL 17 2.2 OBJETIVOS ESPECÍFICOS 17 3. MARCO TEÓRICO 18 3.1 EPIDEMIOLOGÍA 18 3.2 FACTORES DE RIESGO 20 3.2.1 Edad 21 3.2.2 Género 22 3.2.3 Grupo étnico 23 3.2.4 Trastornos psiquiátricos 23 3.2.5 Intento suicida previo 24 3.2.6 Antecedentes familiares 25 3.2.7 Exposición a la violencia o victimización 26 3.2.8 Factores biológicos 26 3.2.9 Acceso a recursos que permitan el suicidio 27 3.2.10 Alcohol y consumo de drogas 27 3.2.11 Exposición al suicidio 27 3.2.12 Estrés social 27 3.2.13 Orientación sexual 28 3.2.14 Factores emocionales y cognitivos 28 4. HIPÓTESIS 30 4.1 ALTERNATIVA 30 5. METODOLOGÍA 31 5.1 TIPO DE INVESTIGACIÓN 31 5.2 UNIVERSO Y MUESTRA 31 5.2.1 Universo 31 5.2.2 Población y muestra 31 5.2.3 Criterios de selección 31 5.2.3.1 Criterios de inclusión 31 5.2.3.2 Criterios de exclusión 31 5.3 DISEÑO MAESTRAL 32 5.3.1 Parámetros 32 5.3.2 Tipo de muestreo 32 5.4 VARIABLES 32 5.5 PROCEDIMIENTO 33 5.5.1 Implementación 33 5.5.2 Prueba piloto 34 5.5.3 Desarrollo 34 5.6 PLAN DE TAB35 5.6.1 Tabulación 35 5.6.2 Análisis 35 5.6.2.1 Análisis descriptivo 35 5.6.2.2 Análisis bivariado 36 5.7 CONTROL DE SESGOS 36 6. CONSIDERACIONES ÉTICAS 38 7. RESULTADOS 40 7.1 ANÁLISIS DESCRIPTIVO 40 7.2 ANÁLISIS BIVARIADO 46 8. DISCUSIÓN 51 9. CONCLUSIONES 54 10. BIBLIOGRAFIA 56 11. ANEXOS 64EspecializaciónIntroduction: In recent years, an increase in the suicide attempt had been observed among young population, however, it is not possible to specifically explain; the higher suicide rates in our country are in the age groups of 15-24 years; being a preventable conduct, an assessment of behavior is necessary in Colombian adolescents. Objective: To determine the prevalence and describe de associated factors for suicidal behavior in adolescents students in grades 9 through 11 in educational institutions from Bogotá. Methods: A questionnaire-based cross-sectional study was conducted to identify prevalence and some associated factors about suicidal behavior, non-probability sampling was used. Bivariate analysis of the variables was performed in the study population. Results: Data were collected on 459 students in six institution applies in Bogota, 41% reported suicidal ideation at some time in their lives, and 20,7% committed at least one suicide attempt throughout their life, the variables associated with suicidal behavior in this population: Female OR=2,36 (1,49-3,76), bisexuality OR 4,64 (1,83-11,77), school dysfunction OR 2,41(1,31-4,44), depression OR= 6,32 (3,46-11,55), suicide attempt by family members OR= 5,33 (3,28, 8,65), personal psychiatric history OR= 4,19 (2,38-7,40) and familiar psychiatric history OR= 2,68 (1,61-4,46). Conclusion: we noted that the outstanding characteristics are depression and suicide attempt by family members. A higher prevalence was found than expected for this age group, a finding that might be explained because not all suicide cases unconsummated consult the health system

Análisis espacial en epidemiología: revisión de métodos

Spatial analysis is a set of techniques that use the geographical locations of the events as input data. The use of spatial analysis techniques in epidemiological studies has been growing rapidly in the last decades because they allow geographic or spatial variability to be included in the analyses. This paper makes a general review of the methods of spatial analysis applied to epidemiology and aims to encourage the study of spatial analysis and promote the incorporation of these techniques in current research. We describe the methods of spatial analysis from the descriptive and analytical approach emphasizing the use, advantages and limitations of choropleth maps, hypothesis tests and the identification of clusters of diseases. El análisis espacial es un conjunto de técnicas que utiliza como insumos la ubicación geográfica o espacial de los eventos que se analizan. El uso de técnicas de análisis espacial en los estudios epidemiológicos ha tenido un rápido crecimiento en las últimas décadas porque permiten incluir en los análisis la variabilidad espacial. En el presente trabajo se hace una revisión general de los métodos de análisis espacial aplicados a la epidemiología y tiene como propósitos incentivar el estudio del análisis espacial y promover la incorporación de estas técnicas en las investigaciones actuales. Se describen los métodos de análisis espacial desde el abordaje descriptivo y analítico haciendo énfasis en el uso, ventajas y limitaciones de mapas coropléticos, pruebas de hipótesis y la identificación de clústers de enfermedades.&nbsp

Risk factors associated with the development of delirium in general ICU patients. A prospective observational study.

Objective We aimed to analyze risk factors related to the development of delirium, aiming for early intervention in patients with greater risk. Material and methods Observational study, including prospectively collected patients treated in a single general ICU. These were classified into two groups, according to whether they developed delirium or not (screening performed using CAM-ICU tool). Demographics and clinical data were analyzed. Multivariate logistic regression analyses were performed to quantify existing associations. Results 1462 patients were included. 93 developed delirium (incidence: 6.3%). These were older, scored higher on the Clinical Frailty Scale, on the risk scores on admission (SAPS-3 and SOFA), and had a greater number of organ failures (OF). We observed more incidence of delirium in patients who (a) presented more than two OF (20.4%; OR 4.9; CI95%: 2.9–8.2), and (b) were more than 74 years old albeit having <2 OF (8.6%; OR 2.1; CI95%: 1.3–3.5). Patients who developed delirium had longer ICU and hospital length-of-stays and a higher rate of readmission. Conclusions The highest risk observed for developing delirium clustered in patients who presented more than 2 OF and patients over 74 years old. The detection of patients at high risk for developing delirium could imply a change in management and improved quality of care.post-print382 K

The effect of comorbidities on glycemic control among Colombian adults with diabetes mellitus: a longitudinal approach with real-world data

Background: Achieving an optimal glycemic control has been described to reduce the incidence of diabetes mellitus (DM) related complications. The association between comorbidities and glycemic control remains unclear. Our aim is to evaluate the effect of comorbidities on glycemic control in people living with DM. Methods: A retrospective longitudinal study on data from the National Registry of Chronic Kidney Disease from 2014 to 2019 in Colombia. The outcome was poor glycemic control (PGC = HbA1c ≥7.0%). The association between each comorbidity (hypertension (HTN), chronic kidney disease (CKD) or obesity) and PGC was evaluated through multivariate mixed effects logistic regression models. The measures of effect were odds ratios (OR) and their 95% confidence intervals (CI). We also evaluated the main associations stratified by gender, insurance, and early onset diabetes as well as statistical interaction between each comorbidity and ethnicity. Results: From 969,531 people at baseline, 85% had at least one comorbidity; they were older and mostly female. In people living with DM and CKD, the odds of having a PGC were 78% (OR: 1.78, CI 95%: 1.55-2.05) higher than those without CKD. Same pattern was observed in obese for whom the odds were 52% (OR: 1.52, CI 95%: 1.31-1.75) higher than in non-obese. Non-significant association was found between HTN and PGC. We found statistical interaction between comorbidities and ethnicity (afro descendant) as well as effect modification by health insurance and early onset DM. Conclusions: Prevalence of comorbidities was high in adults living with DM. Patients with concomitant CKD or obesity had significantly higher odds of having a PGC

The Effects of an Infant Formula Enriched with Milk Fat Globule Membrane, Long-Chain Polyunsaturated Fatty Acids and Synbiotics on Child Behavior up to 2.5 Years Old: The COGNIS Study

Although early life nutrition influences brain development and mental health, the long-term e ects of supplemented infant formula on children´s behavior remain unclear. We analyzed the e ects of a bioactive nutrients-enriched-infant formula on children’s behavior up to 2.5 years, compared to a standard infant formula or breastfeeding. Current analysis involved 70 children who were fed a standard infant formula (SF, n = 29) or a bioactive compounds enriched-infant formula (EF, n = 41), during their first 18 months of life, and 33 breastfed (BF) children (reference group) participating in the COGNIS study. Behavioral problems were evaluated using the Child Behavior Checklist at 18 months and 2.5 years. Di erent statistical analyses were performed using SPSS. EF children aged 2.5 years presented fewer pathological a ective problems than SF children. Besides, SF children were classified more frequently as bordering on internalizing problems than BF children. Rates of externalizing problems were increased in SF infants compared to EF and BF infants. Higher maternal IQ was found to have beneficial e ects on internalizing and total problem rate in their o spring at 18 months of life; finally, higher maternal educational level was related with fewer ADHD problems in children at 18 months, as well as internalizing, externalizing, total and anxiety problems in children aged 2.5 years. Our analysis suggests that enriched infant formula fed infants seem to show fewer behavioral problems up to 2.5 years compared to a standard infant formula-fed infants. In addition to type of early feeding, maternal IQ and educational level seem to play a key role on children behavioral development.Ordesa LaboratoriesS.L. Contract University of Granada General Foundation 3349SMARTFOODS (CIEN) Contract University of Granada General Foundation 4003Spanish Ministry of Economy, Industry and CompetitivenessHORIZON 2020 EU DynaHEALTH Project 633595Fundación Carolina, Madrid, SpainCatedra ORDESA-University of Granada, Spain as part of Special Issue "Early Nutrition and Re-programming of Health and Disease

Growth patterns and breast milk/infant formula energetic efficiency in healthy infants up to 18 months of life: the COGNIS study

This project has been funded by Laboratorios Ordesa, S. L. Contract University of Granada General Foundation, No. 3349 and SMARTFOODS (CIEN) Contract University of Granada General Foundation, No. 4003, Spanish Ministry of Economy, Industry and Competitiveness, and partially funded by HORIZON 2020 EU DynaHEALTH Project (GA No.633595). N. S-V. has been granted with a scholarship from Fundaci ' on Carolina, Madrid, Spain.Type of feeding during early life influences growth trajectory and metabolic risk at later ages. Modifications in infant formula composition have led to evaluate their effects on growth and energetic efficiency (EE) compared with breast-feeding. Main goal was to analyse type of feeding potential effects during first months of life, plus its EE, on growth patterns in healthy formula fed (standard infant formula (SF) vs. experimental infant formula enriched with bioactive nutrients (EF)) and breastfed (BF) infants participating in the COGNIS RCT (http://www.ClinicalTrials.gov, Identifier: NCT02094547) up to 18 months of age. Infants follow-up to 18 months of age (n 141) fed with a SF (n 48), EF(n 56), or BF (n 37), were assessed for growth parameters using WHO standards. Growth velocity (GV) and catch-up were calculated to identify growth patterns. EE of breast milk/infant formula was also estimated. Infants' growth at 6 months showed higher length and lower head circumference gains in SF and EF infants than BF infants. Both weight-for-length and weight-for-age catch-up growth showed significant differences in formula fed groups compared with the BF. No significant differences in GV or catch-up were found at 6-12 and 12-18 months. Regarding EE, infant formula groups showed significantly lower weight and length gains/g of milk protein, and higher weight and length gains/g of milk lipids, than the BF infants. GV during first 6 months, which may be influenced by feeding, seems to be the main predictor of subsequent growth trajectory. Breast-feeding may have positive effects on growth programming due to its nutrients' EE.Laboratorios Ordesa, S. L. Contract University of Granada General Foundation 3349SMARTFOODS (CIEN) Contract University of Granada General Foundation 4003Spanish Ministry of Economy, Industry and CompetitivenessHORIZON 2020 EU DynaHEALTH Project 633595Fundacion Carolina, Madrid, Spai

Cortical Visual Evoked Potentials and Growth in Infants Fed with Bioactive Compounds-Enriched Infant Formula: Results from COGNIS Randomized Clinical Trial

Postnatal nutrition is essential for growth and neurodevelopment. We analyzed the influence of a new enriched-infant formula with bioactive compounds on growth, neurodevelopment, and visual function (VF) in healthy infants during their first 18 months of life. A total of 170 infants were randomized in the COGNIS randomized clinical trial (RCT) to receive a standard infant formula (SF = 85) or a new experimental infant formula supplemented with functional nutrients (EF = 85). As a control, 50 breastfed infants (BF) were enrolled. Growth patterns were evaluated up to 18 months of life; neurodevelopment was assessed by general movements at 2, 3, and 4 months; VF was measured by cortical visual evoked potentials at 3 and 12 months. No differences in growth and neurodevelopment were found between groups. Regarding VF, SF and EF infants presented prolonged latencies and lower amplitudes in the P100 wave than BF infants. In the EF group, a higher percentage of infants presented response at 7 1/2' of arc at 12 months compared to 3 months of age; a similar proportion of BF and EF infants presented responses at 7 1/2' of arc at 12 months of age. Early nutritional intervention with bioactive compounds could narrow the gap in growth and neurodevelopment between breastfed and formula-fed infants.This project has been funded by Ordesa Laboratories, S.L. Contract University of Granada General Foundation, No. 3349 and SMARTFOODS (CIEN) Contract University of Granada General Foundation, No. 4003, Spanish Ministry of Economy, Industry and Competitiveness; funded in part by HORIZON 2020 EU DynaHEALTH Project (GA No.633595)

A synbiotics, long chain polyunsaturated fatty acids, and milk fat globule membranes supplemented formula modulates microbiota maturation and neurodevelopment

Supplementary data to this article can be found online at https://doi.org/10.1016/j.clnu.2022.05.013.Acknowledgments The authors wish to acknowledge the parents and children who participated in the study, and also the paediatricians and researchers of the EURISTIKOS team at the Department of Paediatrics as well as the Genetics Service at Centro de Instrumentación Científica e UGR for their contributions.Funding This project was supported by CDTI (Centro para el Desarrollo Tecnológico e Industrial) and FEDER (SMARTFOODS: IDI-20141206), Ordesa Laboratories, S.L. (Contract FE-UGR No. 3349), and The Spanish Ministry of Economy, Industry and Competitiveness, and partially supported by HORIZON 2020 EU DynaHEALTH Project (GA No.633595). Alicia Ruiz and Inmaculada Acuña were granted Ph.D. scholarships from the Spanish Ministry of Economy and Competitivity. Tomás Cerdó was granted a Ph.D. scholarship from Carlos III Health Institute. Natalia Sepúlveda-Valbuena was granted with a scholarship from Fundación Carolina, Madrid, Spain.Background & aims The critical window of concurrent developmental paths of the nervous system and gut microbiota in infancy provides an opportunity for nutritional interventions with potential health benefits later in life. Methods We compared the dynamics of gut microbiota maturation and explored its association with neurodevelopment at 12 months and 4 years of age in 170 full-term healthy infants fed a standard formula (SF) or a new formula (EF) based on standard formula supplemented with synbiotics, long chain polyunsaturated fatty acids (LC-PUFA) and bovine milk fat globule membranes (MFGM), including a breastfed reference group (BF). Results Using Dirichlet Multinomial Modelling, we characterized three microbial enterotypes (Mixed, anaerobic and aerobic profile; Bact, Bacteroides-dominant; Firm, Firmicutes-enriched) and identified a new enterotype dominated by an unidentified genus within Lachnospiraceae (U_Lach). Enterotypes were associated with age (Mixed with baseline, U_Lach with month 6, Bact and Firm with months 12 and 18). Trajectories or timely enterotype shifts in each infant were not random but strongly associated with type of feeding. Trajectories in SF shifted from initial Mixed to U_Lach, Bact or Firm at month. Microbiota maturation in EF split into a fast trajectory as in SF, and a slow trajectory with Mixed to U_Lach, Bact or Firm transitions at months 12 or 18, as in BF. EF infants with slow trajectories were more often in–home reared and born by vaginal delivery to mothers with pre-pregnancy lean BMI. At 12 months of age, language and expressive language scores were significantly higher in EF infants with fast trajectories than in BF. Neurodevelopmental outcomes were similar between EF infants with slow trajectories and BF at 12 months and 4 years of age. Conclusions Feeding a synbiotics, LC-PUFA and MFGM supplemented formula in a specific infant environment promoted probiotic growth and retarded gut microbiota maturation with similar neurodevelopment outcomes to breastfed infants.CDTI (Centro para el Desarrollo Tecnológico e Industrial) and FEDER (SMARTFOODS: IDI- 20141206)Ordesa Laboratories, S.L. (Contract FE-UGR No. 3349)Spanish Ministry of Economy, Industry and CompetitivenessHORIZON 2020 EU DynaHEALTH Project (GA No.633595

Influence of a Functional Nutrients-Enriched Infant Formula on Language Development in Healthy Children at Four Years Old

Nutrition during early life is essential for brain development and establishes the basis for cognitive and language skills development. It is well established that breastfeeding, compared to formula feeding, has been traditionally associated with increased neurodevelopmental scores up to early adulthood. We analyzed the long-term effects of a new infant formula enriched with bioactive compounds on healthy children’s language development at four years old. In a randomized double-blind COGNIS study, 122 children attended the follow-up call at four years. From them, 89 children were fed a standard infant formula (SF, n = 46) or an experimental infant formula enriched with functional nutrients (EF, n = 43) during their first 18 months of life. As a reference group, 33 exclusively breastfed (BF) were included. Language development was assessed using the Oral Language Task of Navarra-Revised (PLON-R). ANCOVA, chi-square test, and logistic regression models were performed. EF children seemed to show higher scores in use of language and oral spontaneous expression than SF children, and both SF and EF groups did not differ from the BF group. Moreover, it seems that SF children were more frequently categorized into “need to improve and delayed” in the use of language than EF children, and might more frequently present “need to improve and delayed” in the PLON-R total score than BF children. Finally, the results suggest that SF children presented a higher risk of suffering language development than BF children. Secondary analysis also showed a slight trend between low socioeconomic status and poorer language skills. The functional compound-enriched infant formula seems to be associated with beneficial long-term effects in the development of child’s language at four years old in a similar way to breastfed infants.This project has been funded by Ordesa Laboratories, S.L. Contract University of Granada General Foundation, No. 3349 and SMARTFOODS (CIEN) Contract University of Granada General Foundation, No. 4003, Spanish Ministry of Economy, Industry and Competitiveness; funded in part by HORIZON 2020 EU DynaHEALTH Project (GA No.633595). Natalia Sepúlveda-Valbuena has been granted with a scholarship from Fundación Carolina, Madrid, Spai

Informe especial. Minería, conflictos agrarios y ambientales en el sur de La Guajira

Este Informe Especial presenta una descripción de la manera en que se estableció la industria minera en esta región de Colombia y de algunos conflictos agrarios y ambientales generados a partir de la misma. El documento sintetiza el trabajo de investigación que el CINEP/PPP ha desarrollado durante los últimos cuatro años en esta región. En este se identifican las dinámicas que han favorecido a las empresas mineras y a la agenda extractiva por encima de los intereses y necesidades de las comunidades que habitan dicho territorio. El informe busca presentar, a grandes rasgos, la problemática en la región, desde una perspectiva integral, para posteriormente plantear una serie de recomendaciones con el fin de enfrentar las afectaciones causadas a los habitantes de la zona y, si es posible, reparar los daños sobre el territorio, ello a pesar de reconocer que algunos de estos pueden ser irreversibles. Dentro de estos problemas se describen los procesos de adjudicación de baldíos durante la década de los 80 y el papel que estos juegan en la configuración de los conflictos agrarios. Además, se describen las irregularidades en cuanto a los estándares de medición de contaminación en aire, en agua y en general, y el contexto de vulneración de derechos que ha acompañado a la extracción minera en el sur de La Guajira.Resumen ejecutivo Al Gobierno nacional A la comunidad internacional A los Gobiernos locales A la empresa privada A la sociedad civil Introducción Sur de La Guajira: proyecto minero Cerrejón Extracción de carbón Poblaciones en el sur de La Guajira Los conflictos agrarios en el sur de La Guajira Concentración irregular de la tierra: adjudicaciones de baldíos para el carbón Compraventas de predios con antecedentes de baldíos Desalojos Demandas territoriales de las organizaciones campesinas, indígenas y afroguajiras Procesos de reasentamiento involuntario Los conflictos ambientales en el sur de La Guajira Contaminación del agua Análisis de aguas superficiales Inadecuado manejo de aguas de escorrentía y vertimientos de lagunas de oxidación Aguas subterráneas Pérdida del recurso hídrico Abastecimiento de agua Calidad del air