Insecticide resistance levels and associated mechanisms in three Aedes aegypti populations from Venezuela.

BACKGROUND: The massive use of insecticides in public health has exerted selective pressure resulting in the development of resistance in Aedes aegypti to different insecticides in Venezuela. Between 2010 and 2020, the only insecticides available for vector control were the organophosphates (Ops) fenitrothion and temephos which were focally applied. OBJECTIVES: To determine the state of insecticide resistance and to identify the possible biochemical and molecular mechanisms involved in three populations of Ae. aegypti from Venezuela. METHODS: CDC bottle bioassays were conducted on Ae. aegypti collected between October 2019 and February 2020 in two hyperendemic localities for dengue in Aragua State and in a malaria endemic area in Bolívar State. Insecticide resistance mechanisms were studied using biochemical assays and polymerase chain reaction (PCR) to detect kdr mutations. FINDINGS: Bioassays showed contrasting results among populations; Las Brisas was resistant to malathion, permethrin and deltamethrin, Urbanización 19 de Abril was resistant to permethrin and Nacupay to malathion. All populations showed significantly higher activity of mixed function oxidases and glutathione-S-transferases (GSTs) in comparison with the susceptible strain. The kdr mutations V410L, F1534C, and V1016I were detected in all populations, with F1534C at higher frequencies. MAIN CONCLUSION: Insecticide resistance persists in three Ae. aegypti populations from Venezuela even in the relative absence of insecticide application.

Correlation between the analysis of the dentoalveolar square and the photometric clinical diagnosis of smile.

AIM: Increased vertical growth of the maxilla is a condition that affects a large part of the population. The condition reveals a skeletal alteration of the cranio-masticatory system. One of the effects generated by the excessive vertical growth of the maxilla is a gingival smile pattern that can affect esthetic patterns as well as alter the masticatory biomechanics, which is a primary etiologic factor in temporomandibular dysfunction (TMD). Contemporary imaging aids help to optimize diagnostic analysis; perform treatment; and make an evaluation before, during, and after treatment. The present study aims to compare the clinical diagnosis of gingival smile with the dimensions of the dentoalveolar square, digitally calculated in the panoramic projection of the CBCT. MATERIALS AND METHODS: In a sample of 37 patients, an analysis was performed of the correlation between the dimensions of the dentoalveolar square of the Tatis panoramic cephalometry and the clinical photometry, applying the Tjan gingival smile analysis. RESULTS: The results show that there is high correlation and agreement between the cephalometric measurement method of the dentoalveolar square and Tjan's photometric measurement method. Both methods can be used to classify the smile type as high, medium or low. CONCLUSIONS: Analysis of the dentoalveolar square of the panoramic cephalometry provides an accurate diagnosis of the anterior vertical dimension of the maxilla as it relates to the clinical diagnosis of smile.

The impact of secondary forest regeneration on ground-dwelling ant communities in the Tropical Andes.

Natural regeneration of abandoned farmland provides an important opportunity to contribute to global reforestation targets, including the Bonn Challenge. Of particular importance are the montane tropics, where a long history of farming, frequently on marginal soils, has rendered many ecosystems highly degraded and hotspots of extinction risk. Ants play crucial roles in ecosystem functioning, and a key question is how time since abandonment and elevation (and inherent temperature gradients therein) affect patterns of ant recovery within secondary forest systems. Focusing on the Colombian Andes across a 1300 m altitudinal gradient and secondary forest (2-30 years) recovering on abandoned cattle pastures, we find that over time ant community composition and species richness recovered towards that of primary forest. However, these relationships are strongly dependent on elevation with the more open and warmer pasturelands supporting more ants than either primary or secondary forest at a particular elevation. The loss of species richness and change in species composition with elevation is less severe in pasture than forests, suggesting that conditions within pasture and its remaining scattered trees, hedgerows and forest fragments, are more favourable for some species, which are likely in or near thermal debt. Promoting and protecting natural regenerating forests over the long term in the montane tropics will likely offer significant potential for returning ant communities towards primary forest levels.

"I'm Just Forgetting and I Don't Know Why": Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties.

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

A qualitative study on primary health care professionals' perceptions of mental health, suicidal problems and help-seeking among young people in Nicaragua.

BACKGROUND: Mental health problems among young peoples are a growing public health issue around the world. In low- income countries health systems are characterized by lack of facilities, human resources and primary health care is rarely an integrated part of overall health care services. This study aims at exploring how primary health care professionals in Nicaragua perceive young people's mental health problems, suicidal problems and help-seeking behaviour. METHODS: Twelve in-depth interviews were conducted with nurses and doctors working in primary health care services in León, Nicaragua. A qualitative research design was applied. Data was analysed using thematic analysis approach. RESULTS: This study revealed that doctors and nurses were reluctant to deal with young people presenting with suicidal problems at the primary health care. This was more likely to stem from feelings of incompetence rather than from negative attitudes. Other barriers in providing appropriate care to young people with mental health problems were identified such as lack of time, lack of privacy, lack of human resources, lack of trained professionals and difficulties in communicating with young people. The primary health care (PHC) professionals suggested different solutions to improve care for young people with suicidal problems. CONCLUSION: PHC doctors and nurses in Nicaragua felt that providing skilled mental health services to young people was a priority for them but they also identified a number of barriers to be able to do so. They discussed ways to improve young people's willingness to share sensitive issues with them and suggested ways to make PHC more appreciated by young people.

Benefits of being part of a support group for caregivers of children with multiple disabilities: a qualitative study. / Beneficios de pertenecer a un grupo de apoyo de cuidadoras de niños con discapacidad múltiple: un estudio cualitativo.

OBJECTIVE: Motivation for the study. Filling a knowledge gap regarding support groups for caregivers of children with multiple disabilities. Main findings. Support groups are valuable spaces for social support and learning for caregivers of children with multiple disabilities. They facilitate resilience and coping strategies following the birth of a child with multiple disabilities. They promote the participation and empowerment of caregivers of children with multiple disabilities to address access barriers and advocate for the fundamental rights of children. Implications. It is important to promote and support support groups for caregivers of children with multiple disabilities. To explore the perceived benefits of participating in a support group of caregivers of children with multiple disabilities. MATERIALS AND METHODS.: A qualitative study with a focused ethnographic approach was conducted from October 2022 to February 2023, in which we applied convenience sampling. We included 20 caregivers of children with multiple disabilities. Information was collected through participant observation, focus groups, and semi-structured interviews. Thematic analysis was performed by applying Braun and Clark's proposals. RESULTS.: The emerging themes were: social support network: integrating, informing, and helping each other; learning space: learning to take care and to take care of oneself; promoting empowerment: identifying and facing access barriers. CONCLUSIONS.: We found that the support group functions as a social support network provides information, reduces uncertainty, and facilitates coping and resilience after the birth and upbringing of a child with multiple disabilities. It is a space where one learns to care for and take care of oneself and where empowerment for the defense of the rights of children with disabilities is promoted.

OBJETIVO.: Motivación para realizar el estudio. Llenar un vacío de conocimiento sobre los grupos de apoyo de cuidadoras de niños con discapacidad múltiple. Principales hallazgos. Los grupos de apoyo son espacios valiosos de apoyo social y aprendizaje para las cuidadoras de niños con discapacidad múltiple. Facilitan la resiliencia, el afrontamiento tras tener un niño con discapacidad múltiple. Favorecen la participación y empoderamiento de las cuidadoras de niños con discapacidad múltiple para enfrentar barreras de acceso y defender los derechos fundamentales de los niños. Implicancias. Es importante fomentar y respaldar los grupos de apoyo para cuidadoras de niños con discapacidad múltiple. Explorar la percepción de los beneficios de participar en un grupo de apoyo de cuidadoras de niños con discapacidad múltiple. MATERIALES Y MÉTODOS.: Estudio cualitativo, enfoque etnográfico focalizado, realizado de octubre del 2022 a febrero del 2023, muestreo por conveniencia, participaron 20 cuidadoras de niños con discapacidad múltiple. La información se recolectó mediante observación participante, grupos de discusión y entrevistas semiestructuradas. Se realizó análisis temático aplicando las propuestas por Braun y Clark. RESULTADOS.: Los temas emergentes fueron: red de apoyo social: integrarse, informarse y ayudarse mutuamente; espacio de aprendizaje: se aprende a cuidar y a cuidarse; promueve el empoderamiento: identificar y enfrentar barreras de acceso. CONCLUSIONES.: El grupo de apoyo funciona como una red de apoyo social, proporciona información, reduce la incertidumbre, facilita el afrontamiento y la resiliencia tras el nacimiento y crianza de un hijo con discapacidad múltiple. Espacio donde se aprende a cuidar y a cuidarse a sí mismo y donde se promueve el empoderamiento para la defensa de los derechos de los niños con discapacidad.

Morphology and terminology of dung beetles (Coleoptera: Scarabaeidae: Scarabaeinae) male genitalia.

The external and internal male genitalia of 327 species of 11 tribes of the subfamily Scarabaeinae, including species of Deltochilini, Scarabaeini, Gymnopleurini, Ateuchini, and Coprini, among others, were examined. Descriptions of the variations in the genital segment, the aedeagus, the internal sac, and its sclerites and raspules are presented. An exhaustive comparison of structures, names, and terminology used in literature for Scarabaeinae male genitalia are discussed. The internal sac of the aedeagus is divided in areas for an easer comparison of its internal structures; basal, submedial, medial, and apical areas are described in detail and compared. The variation of apical and medial sclerites, as well as the raspules of the submedial area, are described and compared in detail among all the taxa studied.

Taxonomic identification accuracy from BOLD and GenBank databases using over a thousand insect DNA barcodes from Colombia.

Recent declines of insect populations at high rates have resulted in the need to develop a quick method to determine their diversity and to process massive data for the identification of species of highly diverse groups. A short sequence of DNA from COI is widely used for insect identification by comparing it against sequences of known species. Repositories of sequences are available online with tools that facilitate matching of the sequences of interest to a known individual. However, the performance of these tools can differ. Here we aim to assess the accuracy in identification of insect taxonomic categories from two repositories, BOLD Systems and GenBank. This was done by comparing the sequence matches between the taxonomist identification and the suggested identification from the platforms. We used 1,160 COI sequences representing eight orders of insects from Colombia. After the comparison, we reanalyzed the results from a representative subset of the data from the subfamily Scarabaeinae (Coleoptera). Overall, BOLD systems outperformed GenBank, and the performance of both engines differed by orders and other taxonomic categories (species, genus and family). Higher rates of accurate identification were obtained at family and genus levels. The accuracy was higher in BOLD for the order Coleoptera at family level, for Coleoptera and Lepidoptera at genus and species level. Other orders performed similarly in both repositories. Moreover, the Scarabaeinae subset showed that species were correctly identified only when BOLD match percentage was above 93.4% and a total of 85% of the samples were correctly assigned to a taxonomic category. These results accentuate the great potential of the identification engines to place insects accurately into their respective taxonomic categories based on DNA barcodes and highlight the reliability of BOLD Systems for insect identification in the absence of a large reference database for a highly diverse country.

Work Engagement Scale: Construct Validity and Reliability in the Colombian Organizational Context.

This manuscript shows the results of the evidence of content and internal structure obtained from an instrument to measure work engagement. This instrument is aimed at workers of Colombian labor organizations that belong to different economic sectors (commerce, services, education, and health). The instrument was designed based on the postulates of cognitive theory and is structured into three factors that operationalize the construct: (a) behavioral dimension (15 items), (b) affective dimension (16 items), and (c) cognitive dimension (14 items), for a total of 45 items. The results of the content evidence through expert judgment suggested the elimination of three items, due to ambiguity and lack of clarity, leaving the 42item test. After this evidence, the instrument was piloted in a sample of 460 participants. The item-test correlation analysis recommended the elimination of one item due to its low correlation with the factor. The evidence of internal structure through exploratory factor analysis (EFA) proposed a three-factor structure, with an explained variance of 63%; 9 items were eliminated due to high residual. The fit indicators showed a GFI = .99; and those of residual showed a RMSR =.03 and Kelley = .04; each factor obtained an ordinal Cronbach's Alpha of .95 (behavioral), .97 (affective), and .87 (cognitive). These results indicate precision in the measurement and consistency of the items to measure each of the factors.

El presente manuscrito muestra los resultados de la evidencia de contenido y estructura interna obtenidas de un instrumento para medir work engagement. Este instrumento está dirigido a trabajadores de organizaciones laborales colombianas que pertenecen a diferentes sectores económicos (comercio, servicios, educación y salud). El instrumento se diseñó basado en los postulados de la teoría cognitiva y se estructura en tres factores que operacionalizan el constructo: (a) dimensión conductual (15 ítems), (b) dimensión afectiva (16 ítems), y (c) dimensión cognitiva (14 ítems), para un total de 45 ítems.Los resultados de la evidencia de contenido a través del juicio de expertos sugirieron la eliminación de tres ítems, por presentar ambigüedad y poca claridad, quedando la prueba de 42 ítems. Posterior a esta evidencia, se piloteó el instrumento en una muestra de 460 participantes. El análisis de correlación ítem-test recomendó la eliminación de un ítem por presentar baja correlación con el factor. La evidencia de estructura interna a través del análisis factorial exploratorio (AFE) propuso una estructura trifactorial, con una varianza explicada del 63%; se eliminaron 9 ítems por presentar alto residual. Los indicadores de ajuste mostraron un GFI = .99; y los de residual un RMSR = .03 y Kelley = .04; cada factor obtuvo un Alfa de Cronbach ordinal de .95 (conductual), .97 (emocional) y .87 (cognitivo). Estos resultados indican precisión en la medida y consistencia de los ítems para medir cada uno de los factores.

Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis.

OBJECTIVE: The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of these variations, as well as the corresponding prevalence of clinically significant pathologies and complications associated with them. METHODS: The search process was carried out in the following databases; MEDLINE, SCIELO, WOS, CINHAL, SCOPUS, and GOOGLE SCHOLAR, using as search terms; "Maxillary bone," "Maxillary sinus," "Paranasal sinus," "Anatomical variations," "Sinusitis" and "Clinical anatomy." RESULTS: A total of 26 articles and 12969 samples were included, from which 12,594 subjects had their sex recorded giving a total of 5802 males and 6792 females. The variants reported by the included were Haller cells, Concha Bullosa, Number of septa, Hypoplastic sinus, Agger Nasi, Thickening of the MS mucosa, Deviation of the nasal septum, Accessory ostium, and Onodi cells. Among the mentioned, the ones that presented the greatest number of studies (between 8 and 10 studies included) were: the Haller Cells, the Concha Bullosa, and the Number of septa, where prevalence was 0.30, 0.36, 0.39 respectively. These variations can lead to sinusitis, cause some types of tumors, or affect neighboring structures that could be compromised by this variation. CONCLUSION: As a result, it is certainly complex to distinguish the presence of anatomical variations from pathological abnormalities. Therefore, knowledge of the different variations and their clinical relationships could be a useful asset for clinicians dedicated to this region.

Suicidal expressions among young people in Nicaragua and Cambodia: a cross-cultural study.

BACKGROUND: Whereas prevalence of suicidal expressions among young people is fairly similar in different countries, less is known about associated risk factors. This study compares young people in Nicaragua and Cambodia to examine if the pattern of association between mental health problems and suicidal expressions differs. METHODS: 368 and 316 secondary school students, from each country respectively, participated. Self-reported suicidal expressions, exposure to suicidal behavior in significant others and mental health problems among the students were measured using Attitude Towards Suicide (ATTS) and the Youth Self-Report (YSR) questionnaires. RESULTS: Prevalence of serious suicidal expressions (plans and attempts) during recent year, did not differ between countries. Cambodian young people scored significantly higher on all eight YSR-syndromes, except for withdrawn/depressed. In Nicaragua, all YSR-syndromes were significantly associated with serious suicidal expressions in both genders compared to Cambodia where only one syndrome showed an association in each gender; Withdrawn/depressed among girls and Somatic complaints among boys. Associations between being exposed to suicide among significant others and serious suicidal expressions also differed between Cambodia and Nicaragua. CONCLUSIONS: While the magnitude of serious suicidal expressions is similar between these structurally similar but culturally different countries, determinants behave differently. Qualitative studies are warranted to further explore cultural specific determinants for suicidal expressions among young people.

Characteristics and experiences of family caregivers in the mental health setting. / Características y experiencias de los cuidadores familiares en el contexto de la salud mental.

OBJECTIVE.: To describe the characteristics and experiences of family caregivers of persons with mental disorders in a highly complex institution. MATERIALS AND METHODS.: Mixed method, explanatory study, with an initial quantitative and then qualitative sequence. The quantitative phase was carried out using validated instruments: characterization sheet of the person with chronic illness-family caregiver dyad; the Nkongho Caregiving Ability Inventory (CAI), and the Zarit burden scale. The qualitative phase was conducted with a hermeneutic phenomenological approach; the information was collected through in-depth interviews to understand the needs of the caregivers. RESULTS.: The caregivers were mostly women, mainly mothers and daughters, home-occupied and self-employed, with basic primary education, low socioeconomic level and low caregiving skill level; a significant number of caregivers perceived some degree of overload. The themes identified in the analysis of the interviews were: feeling fear before the disease; the experience of caregiver fatigue; losing one's job: another cost of the disease; fear of delegating care; love: a support for the caregiver; needing support to care. CONCLUSIONS.: The caregiver experiences a complex situation associated with the high demand for care, and conditions under which mental health impairment progresses.

OBJETIVO.: Describir las características y experiencias de los cuidadores familiares de personas con trastorno mental, atendidos en una institución de alta complejidad. MATERIALES Y MÉTODOS.: Estudio de método mixto, explicativo, con una secuencia inicial cuantitativa y luego cualitativa. La fase cuantitativa se realizó mediante instrumentos validados: ficha de caracterización de la díada persona con enfermedad crónica-cuidador familiar; el inventario de habilidad de cuidado (CAI) de Nkongho, y la escala de sobrecarga de Zarit. La fase cualitativa se realizó con un enfoque fenomenológico hermenéutico, la información se recolectó mediante entrevistas en profundidad para comprender las necesidades de los cuidadores. RESULTADOS.: Los cuidadores fueron, en su mayoría, mujeres, principalmente madres e hijas, con educación básica primaria, ocupación hogar y dedicados al trabajo independiente, nivel socioeconómico bajo, nivel de habilidad de cuidado bajo y un importante número de cuidadores perciben algún grado de sobrecarga. Los temas identificados en el análisis de las entrevistas fueron: sintiendo miedo ante la enfermedad; la experiencia del cansancio del cuidador; perder el trabajo: otro costo de la enfermedad; el temor de delegar el cuidado; el amor: un soporte para el cuidador; necesitando apoyo para cuidar. CONCLUSIONES.: El cuidador experimenta una situación compleja asociada con la gran demanda de cuidados, y condiciones en que progresa la alteración de la salud mental.

Suicidal Expression in Adolescents in Nicaragua in Relation to Youth Self-Report (YSR) Syndromes and Exposure to Suicide.

BACKGROUND: Suicide and suicidal expressions among young people represent a major public health problem worldwide. Most studies are from high-income countries, and it remains unclear whether prevalence and risk factors show a similar pattern in other settings. This study aims to assess the prevalence of suicidal expressions and serious suicidal expressions (ideation, plans and attempts) among adolescents in Nicaragua, in relation to previously reported risk factors, such as exposure to suicide in significant others (parents, siblings, partners or friends) and mental health problems. METHODS: 368 adolescents aged 15-18 years were randomly selected from public secondary schools in León, Nicaragua. Data was collected using Attitude Towards Suicide (ATTS) and Youth Self-Report questionnaires (YSR). Bivariate and multivariate analyses were conducted. RESULTS: Suicide ideation prevalence in the past year was 22.6%, suicide plans 10.3%, and suicide attempts 6.5%. Girls were significantly more likely to report suicidal ideation. Multivariate analyses showed that anxious/depressed, somatic complaints and exposure to suicidal behavior in significant others were significantly associated with own serious suicidal expressions. CONCLUSIONS: The prevalence of serious suicidal expressions among young people in Nicaragua is within the range reported from Western high-income countries. An attempted or completed suicide in someone close, is associated with own suicidal expressions even in the absence of increased mental distress. Furthermore, somatic complaints should alert health care professionals of the possibility of increased suicide risk.

Detection and assessment of the antibiotic resistance of Enterobacteriaceae recovered from bioaerosols in the Choqueyapu River area, La Paz - Bolivia.

As a highly contaminated waterway flowing through a densely populated urban area, microbiological pollution associated with the Choqueyapu River and the absence of a wastewater treatment plant in La Paz city threatens public health. We collected air samples adjacent to this river using impingement. Laboratory analyses identified the presence of Enterobacteriaceae, reporting a maximum concentration of 86,11 CFU/m3 of sampled air. Positive samples were tested for antibiotic susceptibility against the antibiotics amoxicillin-clavulanic acid, ciprofloxacin, gentamicin, meropenem, sulfamethoxazole-trimethoprim and tetracycline via disk diffusion. The highest percentages of antibiotic resistance were registered for tetracycline (50% of isolates) and sulfamethoxazole-trimethoprim (38,9%), while the lowest resistance profile was reported for meropenem (5,6%). A comparison of results obtained on the pilot studies [elaborated during the wet season of 2018 by Chavez, 2019 and Salazar et al., 2020] and the present study has been done, highlighting seasonal effects over airborne Enterobacteriaceae concentration. Also, it was determined an increase of antibiotic resistance for tetracycline, gentamicin and ciprofloxacin; and a reduction for sulfamethoxazole-trimethoprim, meropenem and amoxicillin-clavulanic acid.

Design and Evaluation of a Hospital-Based Educational Event on Fracture Care for Older Adult.

INTRODUCTION: Surgeons, internal medicine physicians, nurses, and other members of the healthcare team managing older adults with a fracture all have barriers to attending educational courses, including time away from practice and cost. Our planning group decided to create and evaluate a hospital-based educational event to address, meet, and improve the care of older adults with a fracture. MATERIALS AND METHODS: A committee of surgeons and geriatricians defined 3 learning objectives to improve knowledge and attitudes in co-managed care. They designed a 1-day educational event consisting of a departmental visit, a review of cases, a planning session to identify gaps and plan changes, and presentations on selected topics. Thirteen hospitals worldwide completed an 8-question online application form, and 7 sites were selected for delivery over 3 years in Denmark, Colombia, Thailand, Paraguay, Switzerland, and the Dominican Republic. RESULTS: Each event was conducted by 1 or more visiting surgeons and geriatricians, and the local team leaders. The most common challenges reported in the applications were preoperative assessment or optimization, delayed surgery, lack of protocols, access to a geriatrician, teamwork, and specific aspects of perioperative and postoperative care. In each department, 4 or 5 goals and targets for implementation were agreed. The presentations section was customized and attended by 20 to 50 team members. DISCUSSION: Topics selected by a majority of departments were principles of co-managed care (7), preoperative optimization (7), and management of delirium (4). Follow up was conducted after 3 and 12 months to review the degree of achievement of each planned change and to identify any barriers to complete implementation. CONCLUSIONS: Hospital-based events with visiting and local faculty were effective to engage a broader audience that might not attend external courses. A performance improvement component with goal setting and follow up was acceptable to all host departments.

Review of Scatimus Erichson (Coleoptera: Scarabaeidae) in Colombia with the description of a new species.

We present a review of Scatimus Erichson (Coleoptera: Scarabaeidae: Scarabaeinae: Ateuchini: Scatimina) in Colombia, with the description of S. strenua new species from the Central Andes (Antioquia Department). Records of S. strandi Balthasar from southwestern Colombia (Caquetá and Nariño Departments) are validated. The distributions of S. ovatus Harold from the Magdalena, Chocó-Darién, and Sierra Nevada de Santa Marta provinces and S. fernandezi Martínez in the eastern foothills of the Eastern Cordillera (Orinoco-Amazon) are confirmed. New departmental records and distribution maps for Colombia are presented; an updated key for the taxonomic identification of Scatimus is included. With a total of four species, Colombia has the second highest Scatimus species richness of any country.

Perspectives and Consensus among International Orthopaedic Surgeons during Initial and Mid-lockdown Phases of Coronavirus Disease.

With a lot of uncertainty, unclear, and frequently changing management protocols, COVID-19 has significantly impacted the orthopaedic surgical practice during this pandemic crisis. Surgeons around the world needed closed introspection, contemplation, and prospective consensual recommendations for safe surgical practice and prevention of viral contamination. One hundred orthopaedic surgeons from 50 countries were sent a Google online form with a questionnaire explicating protocols for admission, surgeries, discharge, follow-up, relevant information affecting their surgical practices, difficulties faced, and many more important issues that happened during and after the lockdown. Ten surgeons critically construed and interpreted the data to form rationale guidelines and recommendations. Of the total, hand and microsurgery surgeons (52%), trauma surgeons (32%), joint replacement surgeons (20%), and arthroscopy surgeons (14%) actively participated in the survey. Surgeons from national public health care/government college hospitals (44%) and private/semiprivate practitioners (54%) were involved in the study. Countries had lockdown started as early as January 3, 2020 with the implementation of partial or complete lifting of lockdown in few countries while writing this article. Surgeons (58%) did not stop their surgical practice or clinics but preferred only emergency cases during the lockdown. Most of the surgeons (49%) had three-fourths reduction in their total patients turn-up and the remaining cases were managed by conservative (54%) methods. There was a 50 to 75% reduction in the number of surgeries. Surgeons did perform emergency procedures without COVID-19 tests but preferred reverse transcription polymerase chain reaction (RT-PCR; 77%) and computed tomography (CT) scan chest (12%) tests for all elective surgical cases. Open fracture and emergency procedures (60%) and distal radius (55%) fractures were the most commonly performed surgeries. Surgeons preferred full personal protection equipment kits (69%) with a respirator (N95/FFP3), but in the case of unavailability, they used surgical masks and normal gowns. Regional/local anesthesia (70%) remained their choice for surgery to prevent the aerosolized risk of contaminations. Essential surgical follow-up with limited persons and visits was encouraged by 70% of the surgeons, whereas teleconsultation and telerehabilitation by 30% of the surgeons. Despite the protective equipment, one-third of the surgeons were afraid of getting infected and 56% feared of infecting their near and dear ones. Orthopaedic surgeons in private practice did face 50 to 75% financial loss and have to furlough 25% staff and 50% paramedical persons. Orthopaedics meetings were cancelled, and virtual meetings have become the preferred mode of sharing the knowledge and experiences avoiding human contacts. Staying at home, reading, and writing manuscripts became more interesting and an interesting lifestyle change is seen among the surgeons. Unanimously and without any doubt all accepted the fact that COVID-19 pandemic has reached an unprecedented level where personal hygiene, hand washing, social distancing, and safe surgical practices are the viable antidotes, and they have all slowly integrated these practices into their lives. Strict adherence to local authority recommendations and guidelines, uniform and standardized norms for admission, inpatient, and discharge, mandatory RT-PCR tests before surgery and in selective cases with CT scan chest, optimizing and regularizing the surgeries, avoiding and delaying nonemergency surgeries and follow-up protocols, use of teleconsultations cautiously, and working in close association with the World Health Organization and national health care systems will provide a conducive and safe working environment for orthopaedic surgeons and their fraternity and also will prevent the resurgence of COVID-19.

Beneficios de pertenecer a un grupo de apoyo de cuidadoras de niños con discapacidad múltiple: un estudio cualitativo / Benefits of being part of a support group for caregivers of children with multiple disabilities: a qualitative study

RESUMEN Objetivo. Explorar la percepción de los beneficios de participar en un grupo de apoyo de cuidadoras de niños con discapacidad múltiple. Materiales y métodos. Estudio cualitativo, enfoque etnográfico focalizado, realizado de octubre del 2022 a febrero del 2023, muestreo por conveniencia, participaron 20 cuidadoras de niños con discapacidad múltiple. La información se recolectó mediante observación participante, grupos de discusión y entrevistas semiestructuradas. Se realizó análisis temático aplicando las propuestas por Braun y Clark. Resultados. Los temas emergentes fueron: red de apoyo social: integrarse, informarse y ayudarse mutuamente; espacio de aprendizaje: se aprende a cuidar y a cuidarse; promueve el empoderamiento: identificar y enfrentar barreras de acceso. Conclusiones. El grupo de apoyo funciona como una red de apoyo social, proporciona información, reduce la incertidumbre, facilita el afrontamiento y la resiliencia tras el nacimiento y crianza de un hijo con discapacidad múltiple. Espacio donde se aprende a cuidar y a cuidarse a sí mismo y donde se promueve el empoderamiento para la defensa de los derechos de los niños con discapacidad.

ABSTRACT Objective . To explore the perceived benefits of participating in a support group of caregivers of children with multiple disabilities. Materials and methods. A qualitative study with a focused ethnographic approach was conducted from October 2022 to February 2023, in which we applied convenience sampling. We included 20 caregivers of children with multiple disabilities. Information was collected through participant observation, focus groups, and semi-structured interviews. Thematic analysis was performed by applying Braun and Clark's proposals. Results. The emerging themes were: social support network: integrating, informing, and helping each other; learning space: learning to take care and to take care of oneself; promoting empowerment: identifying and facing access barriers. Conclusions. We found that the support group functions as a social support network provides information, reduces uncertainty, and facilitates coping and resilience after the birth and upbringing of a child with multiple disabilities. It is a space where one learns to care for and take care of oneself and where empowerment for the defense of the rights of children with disabilities is promoted.

Strategies Employed by Community-Based Service Providers to Address HIV-Associated Neurocognitive Challenges: A Qualitative Study.

BACKGROUND: HIV-associated neurocognitive disorders and other causes of neurocognitive challenges experienced by people living with HIV (PLWH) persist as public health concerns in developed countries. Consequently, PLWH who experience neurocognitive challenges increasingly require social support and mental health services from community-based providers in the HIV sector. METHODS: Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed to determine the strategies they used to support PLWH experiencing neurocognitive difficulties. Thematic analysis was conducted to determine key themes from the interview data. RESULTS: Three types of strategies were identified: (a) intrapersonal, (b) interpersonal, and (c) organizational. Intrapersonal strategies involved learning and staying informed about causes of neurocognitive challenges. Interpersonal strategies included providing practical assistance, information, counseling, and/or referrals to PLWH. Organizational strategies included creating dedicated support groups for PLWH experiencing neurocognitive challenges, partnering with other organizations with services not available within their own organization, and advocating for greater access to services with expertise and experience working with PLWH. CONCLUSION: Through concerted efforts in the future, it is likely that empirically investigating, developing, and customizing these strategies specifically to address HIV-associated neurocognitive challenges will yield improved social support and mental health outcomes for PLWH.

Homecare skills and overburden of caregivers of hospitalized chronic patients / Competência de cuidado e sobrecarga do cuidador da pessoa com doença crônica hospitalizada / Competencia del cuidar y sobrecarga del cuidador de la persona con enfermedad crónica hospitalizada

Objective: To describe care competence and its association with overburden of caregivers of patients with chronic diseases. Method: Quantitative, descriptive, cross-sectional study, with a convenience sample. Three instruments were used for data collection: the GCPC-UN instrument for caregiver-patient characterization, the Homecare Skills Questionnaire (CUIDAR, as per its name in Spanish), and the Zarit Burden Interview. Participants in this study were 102 caregivers of people hospitalized in a health institution who met the inclusion criteria. Results: Caregivers were mainly women, had a low level of education, high burden (56.8%), and high level of care competence (68.6%). A statistically significant correlation was found between overburden and overall scores on the CUIDAR instrument, as well as with the following categories: knowledge, uniqueness and anticipation. Conclusion: Homecare competence is associated with overburden of caregivers of people with CNCDs. Therefore, nursing teams have to identify the needs of caregivers and take action so as to contribute to seamless transitions to patients' homes.