Description of a telehealth mental health programme in the framework of the COVID-19 pandemic in Colombia.

BACKGROUND: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia]. OBJECTIVES: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021. METHODS: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics. RESULTS: In March 2020 and August 2021, 10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person. CONCLUSIONS: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.

Descripción de un Programa de Telesalud Mental en el Marco de la Pandemia de COVID-19 en Colombia / Description of a Telehealth Mental Health Programme in the Framework of the COVID-19 Pandemic in Colombia

RESUMEN Introducción: En el LivingLab de la Facultad de Medicina de la Universidad de Antioquia se diseñó un programa de telesalud mental. Objetivo: Describir el desarrollo y el funcionamiento del programa y evaluar la satisfacción de los pacientes atendidos en 2020 y 2021 durante la pandemia de COVID-19. Métodos: Estudio descriptivo que detalla el desarrollo del programa. Se extrajeron los datos de las historias clínicas para describir a los pacientes atendidos. Se aplicó una escala de satisfacción a una muestra aleatoria y se resumieron los datos con estadística descriptiva. Resultados: Durante marzo de 2020 y agosto de 2021, se atendió a 10.229 pacientes con 20.276 atenciones por telepsicología y 4.164 por psiquiatría, 1.808 en la modalidad de telepsiquiatría y 2.356 en la de teleexperticia, con un total de 6.312 atenciones. Los diagnósticos más frecuentes fueron trastornos depresivos (36,8%), ansiosos (12,0%) y psicóticos (10,8%). Los encuestados se mostraron satisfechos, al punto de que más del 93% recomendaría el programa a otra persona. Conclusiones: El programa de telesalud mental del LivingLab permitió la atención de pacientes de Antioquia con problemas y trastornos mentales durante los primeros 2 años de la pandemia de COVID-19 y los beneficiarios mostraron un alto grado de satisfacción, por lo que podría adoptarse para la atención en salud mental.

ABSTRACT Background: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia]. Objectives: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021. Methods: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics. Results: In March 2020 and August 2021,10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person. Conclusions: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.

[Description of a telehealth mental health programme in the framework of the COVID-19 pandemic in Colombia]. / Descripción de un programa de telesalud mental en el marco de la pandemia de COVID-19 en Colombia.

Background: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia].Objectives: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021.Methods: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics.Results: In March 2020 and August 2021, 10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person.Conclusions: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.

Socioeconomically Disadvantaged Groups and Metabolic Syndrome in European Adolescents: The HELENA Study.

PURPOSE: Psychosocial stressors derived from socioeconomic disadvantages in adolescents can result in higher risk of metabolic syndrome (MetS). We aimed to examine whether socioeconomic disadvantages were associated with MetS independent of lifestyle and whether there was a dose-response relationship between the number of cumulated socioeconomic disadvantages and risk of MetS. METHODS: This study included 1,037 European adolescents (aged 12.5-17.5 years). Sociodemographic variables and lifestyle were assessed by self-reported questionnaires. Disadvantaged groups included adolescents with low-educated parents, low family affluence, migrant origin, unemployed parents, and nontraditional families. MetS risk score was calculated as the sum of sex- and age-specific z-scores of waist circumference, blood pressure, lipids, and insulin resistance. Linear mixed-effects models adjusted for sex, age, pubertal status, and lifestyle were used to study the association between social disadvantages and MetS risk score. RESULTS: Adolescents with low-educated mothers showed a higher MetS score (.54 [.09-.98]; ß estimate and 99% confidence interval) compared to those with high-educated mothers. Adolescents who accumulated more than three disadvantages (.69 [.08-1.31]) or with missing information on disadvantages (.72 [.04-1.40]) had a higher MetS risk score compared to nonsocioeconomically disadvantaged groups. Stronger associations between socioeconomic disadvantages and MetS were found in male than in female adolescents. CONCLUSIONS: Adolescents with low-educated mothers or with more than three socioeconomic disadvantages had a higher MetS risk, independent of lifestyle, potentially due to higher psychosocial stress exposure. Policy makers should focus on improving low-educated familiesa and more disadvantaged families' knowledge on nutrition and physical activity to help them cope better with stress.

Do dietary patterns determine levels of vitamin B6, folate, and vitamin B12 intake and corresponding biomarkers in European adolescents? The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study.

OBJECTIVES: To determine dietary patterns (DPs) and explain the highest variance of vitamin B6, folate, and B12 intake and related concentrations among European adolescents. METHODS: A total of 2173 adolescents who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence study met the eligibility criteria for the vitamin B intake analysis (46% boys) and 586 adolescents for the biomarkers analysis (47% boys). Two non-consecutive, 24-h, dietary recalls were used to assess the mean intakes. Concentrations were measured by chromatography and immunoassay testing. A reduced rank regression was applied to elucidate the combined effect of food intake of vitamin B and related concentrations. RESULTS: The identified DPs (one per vitamin B intake and biomarker and by sex) explained a variability between 34.2% and 23.7% of the vitamin B intake and between 17.2% and 7% of the biomarkers. In the reduced rank regression models, fish, eggs, cheese, whole milk and buttermilk intakes were loaded positively for vitamin B intake in both sexes; however, soft drinks and chocolate were loaded negatively. For the biomarkers, a higher variability was observed in the patterns in terms of food loads such as alcoholic drinks, sugars, and soft drinks. Some food items were loaded differently between intakes and biomarkers such as fish products, which was loaded positively for intakes but negatively for plasma folate in girls. CONCLUSIONS: The identified DPs explained up to 34.2% and 17.2% of the variability of the vitamin B intake and plasma concentrations, respectively, in European adolescents. Further studies are needed to elucidate the factors that determine such patterns.

Hemodynamic and Cardiorespiratory Predictors of Sport Rock Climbing Performance.

Fryer, SM, Giles, D, Garrido Palomino, I, de la O Puerta, A, and España-Romero, V. Hemodynamic and cardiorespiratory predictors of sport rock climbing performance. J Strength Cond Res 32(12): 3543-3550, 2018-Rock climbing performance has been suggested to involve a notable contribution from aerobic metabolism. Previously, it has been shown that forearm oxygenation kinetics can be used to distinguish ability groups and predict red-point sport climbing performance. Currently, it is not known if forearm oxygenation kinetics or a sport-specific assessment of cardiorespiratory fitness best predicts sport rock climbing performance. The aim of the study was to determine whether forearm oxidative capacity index, maximal deoxygenation (Δ score) during a treadwall V[Combining Dot Above]O2peak test, treadwall V[Combining Dot Above]O2peak, or running V[Combining Dot Above]O2max best predicts self-reported sport climbing performance. Twenty-one male sport rock climbers completed a treadwall V[Combining Dot Above]O2peak, running V[Combining Dot Above]O2max, and an assessment of near-infrared spectroscopy-derived oxidative capacity index. Linear regression, adjusted for age and experience (years), revealed that forearm oxidative capacity index, treadwall maximal deoxygenation (Δ), and treadwall V[Combining Dot Above]O2peak all significantly predicted self-reported red-point sport climbing ability (Adj R = -0.398, -0.255, and 0.374, respectively), whereas treadmill running V[Combining Dot Above]O2max did not (Adj R = -0.052). Additionally, multiple regression suggested that the combined significant aerobic predictors accounted for 67% of the variance in red-point climbing ability. Findings suggest that training for sport rock climbing performance should look to incorporate modalities that focus on (a) improving local forearm aerobic capacity and (b) improving whole-body aerobic capacity using sport-specific apparatus, such as treadwalls.

Attention capacity in European adolescents: role of different health-related factors. The HELENA study.

We compared the level of attention capacity between adolescents from the center and south of Europe. The study included 627 European adolescents (54% girls), aged 12.5-17.5 years, who participated in the HELENA Study. The d2 Test of Attention was administered to assess attention capacity. The main results showed that adolescents from the south of Europe had significantly higher score in attention capacity compared with adolescents from central Europe (score + 8.1; 95%CI, 2.44-13.61) after adjustment for age, sex, socioeconomic indicators, body mass index, cardiorespiratory fitness and diet quality index (p = 0.012). CONCLUSION: Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from central Europe independently of sociodemographic and health-related factors. These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student's capacities. What is Known? • Attention is a crucial capacity during adolescence. • Several health-related factors (i.e., physical activity, fitness or fatness) may influence attention capacity in adolescents. What is New? • Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from the center, after accounting for socioeconomic factors, fitness, fatness and quality of diet. • These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student's capacities.

[Associations between insulin resistance and three B-vitamins in European adolescents: the HELENA study].

OBJECTIVE: To assess whether adolescents with high body mass index (BMI), or fat mass index (FMI), in combination with insulin resistance (assessed with the Homeostatic Model Assessment [HOMA] index), had also lower blood vitamin B6, folate and vitamin B12 concentrations. METHODS AND MATERIALS: Six hundred and fifteen adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, with data on B-vitamins (both intakes and status), and BMI, FMI, HOMA, were selected. Intakes were assessed by two non-consecutive 24-h recalls. B-vitamins biomarkers were measured by chromatography and immunoassay. Analysis of covariance was applied to elucidate the differences in B-vitamins between combinations of groups defined according to the median of the z-scores of markers of body composition and insulin sensitivity. RESULTS: When considering energy intakes and education of the mother in the model, in females, vitamin B6 intakes were higher in the high BMI/high HOMA group than in the high BMI-low HOMA group. Similarly, vitamin B6 intakes were higher in the high FMI/high HOMA group than in the low FMI/low HOMA group. Plasma vitamin B12 was significantly lower in males in the high FMI/high HOMA group than in the low FMI/low HOMA group, keeping also significant their trends throughout the groups, a fact that can be observed also for females (p < 0.05). CONCLUSION: Adolescents with combined higher adiposity and higher HOMA insulin sensitivity showed lower vitamin B12 plasma concentrations. These differences do not seem to be explained by dietary vitamin B12 intake.

Prognostic value of computed tomography pulmonary angiography indices in patients with cancer-related pulmonary embolism: Data from a multicenter cohort study.

OBJECTIVE: To analyze the prognostic value of pulmonary artery obstruction versus right-ventricle (RV) dysfunction radiologic indices in cancer-related pulmonary embolism (PE). METHODS: We enrolled 303 consecutive patients with paraneoplastic PE, evaluated by computed tomography pulmonary angiography (CTPA) between 2013 and 2014. The primary outcome measure was serious complications at 15days. Multivariate analyses were conducted by using binary logistic and robust regressions. Radiological features such as the Qanadli index (QI) and RV dysfunction signs were analyzed with Spearman's partial rank correlations. RESULTS: RV diameter was the only radiological variable associated with an adverse outcome. Subjects with enlarged RV (diameter>45mm) had more 15-day complications (58% versus 40%, p=0.001). The QI correlated with the RV diameter (r=0.28, p<0.001), left ventricle diameter (r=-0.19, p<0.001), right ventricular-to-left ventricular diameter ratio (r=0.39, p<0.001), pulmonary artery diameter (r=0.22, p<0.001), and pulmonary artery/ascending aorta ratio (r=0.27, p<0.001). A QI≥50% was only associated with 15-day complications in subjects with enlarged RV, inverted intraventricular septum, or chronic cardiopulmonary diseases. The central or peripheral PE location did not affect the correlations among radiological variables and was not associated with clinical outcomes. CONCLUSIONS: Right ventricular dysfunction signs in CTPA are more useful than QI in predicting cancer-related PE outcome.

Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study.

The study aimed to identify predictors of overall 30-day mortality in cancer patients with pulmonary embolism including suspected pulmonary embolism (SPE) and unsuspected pulmonary embolism (UPE) events. Secondary outcomes included 30- and 90-day major bleeding and venous thromboembolism (VTE) recurrence.The study cohort included 1033 consecutive patients with pulmonary embolism from the multicentre observational ambispective EPIPHANY study (March 2006-October 2014). A subgroup of 497 patients prospectively assessed for the study were subclassified into three work-up scenarios (SPE, truly asymptomatic UPE and UPE with symptoms) to assess outcomes.The overall 30-day mortality rate was 14%. The following variables were associated with the overall 30-day mortality on multivariate analysis: VTE history, upper gastrointestinal cancers, metastatic disease, cancer progression, performance status, arterial hypotension <100 mmHg, heart rate >110 beats·min-1, basal oxygen saturation <90% and SPE (versus overall UPE).The overall 30-day mortality was significantly lower in patients with truly asymptomatic UPE events (3%) compared with those with UPE-S (20%) and SPE (21%) (p<0.0001). Thirty- and 90-day VTE recurrence and major bleeding rates were similar in all the groups.In conclusion, variables associated with the severity of cancer and pulmonary embolism were associated with short-term mortality. Our findings may help to develop pulmonary embolism risk-assessment models in this setting.

Differences in Oxygenation Kinetics Between the Dominant and Nondominant Flexor Digitorum Profundus in Rock Climbers.

PURPOSE: To examine differences in oxygenation kinetics in the nondominant and dominant flexor digitorum profundus (FDP) of rock climbers. METHODS: Participants were 28 sport climbers with a range of on-site abilities (6a+ to 8a French Sport). Using near-infrared spectroscopy, oxygenation kinetics of the FDP was assessed by calculating the time to half recovery (t1/2 recovery) of the tissue-saturation index (TSI) after 3-5 min of ischemia. RESULTS: A 2-way mixed-model ANOVA found a nonsignificant interaction (P = .112) for TSI by sex. However, there was a significant main effect (P = .027) of handedness (dominant vs nondominant FDP). The dominant forearm recovered 13.6% faster (t1/2 recovery mean difference = 1.12 s, 95% CI 0.13-2.10 s) than the nondominant FDP. This was not affected by 6-mo on-site climbing ability or sex (P = .839, P = .683). CONCLUSIONS: Significant intraindividual differences in oxygenation kinetics of the FDP were found. Improvements in oxygenation kinetics in the FDP are likely due to the abilities of the muscle to deliver, perfuse, and consume oxygen. These enhancements may be due to structural adaptations in the microvasculature, such as an increase in capillary density and enhanced improvement in capillary filtration.

Identification and functional analysis of pistil self-incompatibility factor HT-B of Petunia.

Gametophytic self-incompatibility (GSI) in Solanaceae, Rosaceae, and Plantaginaceae is controlled by a multiallelic S-locus. The specificities of pistil and pollen are controlled by separate S-locus genes, S-RNase and SLF/SFB, respectively. Although the S-specificity is determined by the S-locus genes, factors located outside the S-locus are also required for expression of GSI. HT-B is one of the pistil non-S-factors identified in Nicotiana and Solanum, and encodes a small asparagine/aspartate-rich extracellular protein with unknown biochemical function. Here, HT-B was cloned from Petunia and characterized. The structural features and expression pattern of Petunia HT-B were very similar to those of Nicotiana and Solanum. Unlike other solanaceous species, expression of HT-B was also observed in self-compatible Petunia species. RNA interference (RNAi)-mediated suppression of Petunia HT-B resulted in partial breakdown of GSI. Quantitative analysis of the HT-B mRNA accumulation in the transgenics showed that a 100-fold reduction is not sufficient and a >1000-fold reduction is required to achieve partial breakdown of GSI.