Chikungunya outbreak (2015) in the Colombian Caribbean: Latent classes and gender differences in virus infection.

Chikungunya virus (CHIKV), a mosquito-borne alphavirus of the Togaviridae family, is part of a group of emergent diseases, including arbovirus, constituting an increasing public health problem in tropical areas worldwide. CHIKV causes a severe and debilitating disease with high morbidity. The first Colombian autochthonous case was reported in the Colombian Caribbean region in September 2014. Within the next two to three months, the CHIKV outbreak reached its peak. Although the CHIKV pattern of clinical symptomatology has been documented in different epidemiological studies, understanding of the relationship between clinical symptomatology and variation in phenotypic response to CHIKV infection in humans remains limited. We performed a cross sectional study following 1160 individuals clinically diagnosed with CHIKV at the peak of the Chikungunya outbreak in the Colombian Caribbean region. We examined the relationship between symptomatology and diverse phenotypic responses. Latent Class Cluster Analysis (LCCA) models were used to characterize patients' symptomatology and further identify subgroups of individuals with differential phenotypic response. We found that most individuals presented fever (94.4%), headache (73.28%) and general discomfort (59.4%), which are distinct clinical symptoms of a viral infection. Furthermore, 11/26 (43.2%) of the categorized symptoms were more frequent in women than in men. LCCA disclosed seven distinctive phenotypic response profiles in this population of CHIKV infected individuals. Interestingly, 282 (24.3%) individuals exhibited a lower symptomatic "extreme" phenotype and 74 (6.4%) patients were within the severe complex "extreme" phenotype. Although clinical symptomatology may be diverse, there are distinct symptoms or group of symptoms that can be correlated with differential phenotypic response and perhaps susceptibility to CHIKV infection, especially in the female population. This suggests that, comparatively to men, women are a CHIKV at-risk population. Further study is needed to validate these results and determine whether the distinct LCCA profiles are a result of the immune response or a mixture of genetic, lifestyle and environmental factors. Our findings could contribute to the development of machine learning approaches to characterizing CHIKV infection in other populations. Preliminary results have shown prediction models achieving up to 92% accuracy overall, with substantial sensitivity, specificity and accuracy values per LCCA-derived cluster.

Health-Related Quality of Life of an adult population sample in Barranquilla, Colombia.

OBJECTIVE: The aim of this study was to estimate values of health-related quality of life (HRQOL) by focusing on the physical and mental health of an adult population sample in the city of Barranquilla, Colombia. MATERIALS AND METHODS: Cross-sectional study with 368 adults representing an adult population. The questionnaires included the health-related quality of life "CDC-Healthy Days", the Zung Self-Rating Depression Scale, and the Overall Disability Sum Score. The prevalence of fair or poor health status (FPH), frequent physical distress (FPD), frequent mental distress (FMD), and frequent activity limitation (FAL) was estimated according to socio-demographic characteristics, presence of depression, and physical disability. RESULTS: The mean age of 368 adults was 45.6 ± 18.3 years; 55.7% were males. Only 21% of this population considered their general health to be fair or poor. The prevalence of FPH, FPD, FMD and FAL was higher in women than in men, and increased with greater severity of depression and higher physical disability. Moreover, 12% of the population presented with mild depression, 3.8% with moderate depression, and less than 1% with severe depression. 94% of this population did not have an arms or legs disability. DISCUSSION: This study provides HRQOL values for an adult sample of the population of Barranquilla, Colombia. Overall, the HRQOL of this population, with subtle differences, is similar to other reports from Colombia. In general, women and people with depression and physical disabilities had a worse quality of life.

Sex differences in brain correlates of STEM anxiety.

Anxiety is known to dysregulate the salience, default mode, and central executive networks of the human brain, yet this phenomenon has not been fully explored across the STEM learning experience, where anxiety can impact negatively academic performance. Here, we evaluated anxiety and large-scale brain connectivity in 101 undergraduate physics students. We found sex differences in STEM-related and clinical anxiety, with longitudinal increases in science anxiety observed for both female and male students. Sex-specific relationships between STEM anxiety and brain connectivity emerged, with male students exhibiting distinct inter-network connectivity for STEM and clinical anxiety, and female students demonstrating no significant within-sex correlations. Anxiety was negatively correlated with academic performance in sex-specific ways at both pre- and post-instruction. Moreover, math anxiety in male students mediated the relation between default mode-salience connectivity and course grade. Together, these results reveal complex sex differences in the neural mechanisms driving how anxiety is related to STEM learning.

Brain activity links performance in science reasoning with conceptual approach.

Understanding how students learn is crucial for helping them succeed. We examined brain function in 107 undergraduate students during a task known to be challenging for many students-physics problem solving-to characterize the underlying neural mechanisms and determine how these support comprehension and proficiency. Further, we applied module analysis to response distributions, defining groups of students who answered by using similar physics conceptions, and probed for brain differences linked with different conceptual approaches. We found that integrated executive, attentional, visual motion, and default mode brain systems cooperate to achieve sequential and sustained physics-related cognition. While accuracy alone did not predict brain function, dissociable brain patterns were observed when students solved problems by using different physics conceptions, and increased success was linked to conceptual coherence. Our analyses demonstrate that episodic associations and control processes operate in tandem to support physics reasoning, offering potential insight to support student learning.

Toward a Neurobiological Basis for Understanding Learning in University Modeling Instruction Physics Courses.

Modeling Instruction (MI) for University Physics is a curricular and pedagogical approach to active learning in introductory physics. A basic tenet of science is that it is a model-driven endeavor that involves building models, then validating, deploying, and ultimately revising them in an iterative fashion. MI was developed to provide students a facsimile in the university classroom of this foundational scientific practice. As a curriculum, MI employs conceptual scientific models as the basis for the course content, and thus learning in a MI classroom involves students appropriating scientific models for their own use. Over the last 10 years, substantial evidence has accumulated supporting MI's efficacy, including gains in conceptual understanding, odds of success, attitudes toward learning, self-efficacy, and social networks centered around physics learning. However, we still do not fully understand the mechanisms of how students learn physics and develop mental models of physical phenomena. Herein, we explore the hypothesis that the MI curriculum and pedagogy promotes student engagement via conceptual model building. This emphasis on conceptual model building, in turn, leads to improved knowledge organization and problem solving abilities that manifest as quantifiable functional brain changes that can be assessed with functional magnetic resonance imaging (fMRI). We conducted a neuroeducation study wherein students completed a physics reasoning task while undergoing fMRI scanning before (pre) and after (post) completing a MI introductory physics course. Preliminary results indicated that performance of the physics reasoning task was linked with increased brain activity notably in lateral prefrontal and parietal cortices that previously have been associated with attention, working memory, and problem solving, and are collectively referred to as the central executive network. Critically, assessment of changes in brain activity during the physics reasoning task from pre- vs. post-instruction identified increased activity after the course notably in the posterior cingulate cortex (a brain region previously linked with episodic memory and self-referential thought) and in the frontal poles (regions linked with learning). These preliminary outcomes highlight brain regions linked with physics reasoning and, critically, suggest that brain activity during physics reasoning is modifiable by thoughtfully designed curriculum and pedagogy.

Zika virus disease-associated Guillain-Barré syndrome-Barranquilla, Colombia 2015-2016.

BACKGROUND: An outbreak of Guillain-Barré syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS. METHODS: We used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015-April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and ≥2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: We confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those ≥60years versus those <20years). We interviewed 40 case-patients and 79 controls. There was no significant difference in laboratory evidence of recent Zika virus or flavivirus infection between case-patients and controls (OR: 2.2; 95% CI: 0.9-5.1). GBS was associated with having suspected (OR: 3.0, 95% CI: 1.1-8.6) or probable Zika virus disease (OR: 4.6, CI: 1.1-19.0). CONCLUSIONS: Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS. KEY POINTS: We confirmed a Guillain-Barré syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015-April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS.

Health-related quality of Life of an adult population sample in Barranquilla, Colombia / Calidad de vida relacionada con salud en una muestra de población adulta en Barranquilla, Colombia

ABSTRACT Objective The aim of this study was to estimate values of health-related quality of life (HRQOL) by focusing on the physical and mental health of an adult population sample in the city of Barranquilla, Colombia. Materials and Methods Cross-sectional study with 368 adults representing an adult population. The questionnaires included the health-related quality of life "CDC-Healthy Days", the Zung Self-Rating Depression Scale, and the Overall Disability Sum Score. The prevalence of fair or poor health status (FPH), frequent physical distress (FPD), frequent mental distress (FMD), and frequent activity limitation (FAL) was estimated according to socio-demographic characteristics, presence of depression, and physical disability. Results The mean age of 368 adults was 45.6 ± 18.3 years; 55.7% were males. Only 21% of this population considered their general health to be fair or poor. The prevalence of FPH, FPD, FMD and FAL was higher in women than in men, and increased with greater severity of depression and higher physical disability. Moreover, 12% of the population presented with mild depression, 3.8% with moderate depression, and less than 1% with severe depression. 94% of this population did not have an arms or legs disability. Discussion This study provides HRQOL values for an adult sample of the population of Barranquilla, Colombia. Overall, the HRQOL of this population, with subtle differences, is similar to other reports from Colombia. In general, women and people with depression and physical disabilities had a worse quality of life.(AU)

RESUMEN Objetivo Estimar los valores de la calidad de vida relacionada con la salud (CVRS) enfocados en la salud física y mental de una muestra de población adulta en la ciudad de Barranquilla, Colombia. Métodos Estudio transversal, con 368 adultos. Los cuestionarios consistían en escala de calidad de vida relacionada con la salud "CDC-Healthy Days", la Escala de Depresión de Zung y el Puntaje General de la Discapacidad. La prevalencia del estado de salud regular o deficiente (FPH), el estrés físico frecuente (FPD), el estrés mental frecuente (FMD) y la limitación de la actividad frecuente (FAL) se estimaron según las características sociodemográficas, la presencia de depresión y la discapacidad física. Resultados La edad promedio de los 368 adultos fue de 45.6 ± 18.3 años, 55.7% fueron hombres. El 21% de esta población consideraba que su salud general era justa o pobre. La prevalencia de FPH, FPD, FMD y FAL fue mayor en mujeres que en hombres; incrementó con mayor severidad de depresión y con mayor discapacidad física en esta población. El 12% tenía depresión leve, 3.8% tenía depresión moderada y menos del 1% depresión grave. El 94% de esta población no tenía una discapacidad de brazos o piernas. Discusión Este estudio proporciona valores de CVRS en una muestra adulta de la población de Barranquilla, Colombia. En general, la CVRS de esta población, con pequeñas diferencias, es similar a otros estudios de Colombia. En general, las mujeres, las personas con depresión y discapacidades físicas tenían una peor calidad de vida.(AU)

Necesidades percibidas de salud por los migrantes desde Venezuela en el asentamiento de Villa Caracas - Barranquilla, 2018: reporte de caso en salud pública / Perceived health needs by migrants from Venezuela residing in the Villa Caracas Settlement, Barranquilla, 2018: public health case report

Resumen Introducción: Actualmente existe un fenómeno inédito para Colombia de migración masiva desde Venezuela que representa grandes retos para la sociedad y el sistema de salud colombiano. Barranquilla es uno de los principales municipios receptores en el norte del país. En esta ciudad, los asentamientos de zonas marginadas están siendo habitados por migrantes venezolanos y colombianos de retorno, a menudo en condiciones de alta vulnerabilidad ambiental y social. Objetivo: El presente estudio realiza una exploración rápida de las necesidades sociales y en salud del asentamiento de Villa Caracas, usando una técnica semi-cualitativa de listados libres para explorar los dominios culturales asociados a tales necesidades. Presentación de caso: Villa Caracas, se encuentra en el Suroccidente de Barranquilla y se cree que la ocupan alrededor de unas 100 familias de venezolanos, sumados a los colombianos de retorno y nativos que nunca se re-ubicaron. Sus habitantes se encuentran en condiciones de vulnerabilidad, pero no se conocen cuáles son las problemáticas más relevantes. Métodos: Se aplicaron 96 listados libres en habitantes de Villa Caracas, a cada sujeto se les interrogó el sexo, la edad, la ocupación, la escolaridad y su estado migratorio. Se hicieron tres preguntas para los listados libres sobre: problemas del asentamiento, problemas de salud, y puntos donde reciben atención en salud. Se calcularon los índices de relevancia de Smith (IRS) para cada dominio. Resultados: En total participaron 96 personas, de los cuales 33 fueron hombres. La edad promedio fue de 31,2 años (SD: 9,6; Rango: 18-65). Del total de la muestra, un 82,3% fueron venezolanos, 8,3% colombianos de retorno y un 9,4% manifestó tener doble nacionalidad. Todos los venezolanos participantes se encontraban en condición migratoria irregular. Se encontraron como principales necesidades sociales percibidas las siguientes: alcantarillado (Índice de relevancia de Smith (IRS): 0,38), agua potable (IRS: 0,31) y fluido eléctrico (IRS: 0,30). Por otro lado, con respecto a los problemas de salud, resaltaron: infección respiratoria aguda (IRS: 0,39) y fiebre no especificada (0,20). Todos los habitantes refirieron no ser atendidos por ser venezolanos. Conclusiones: La aproximación permite destacar las condiciones de vulnerabilidad de los migrantes siendo un punto de partida para un diagnóstico más detallado que permita el desarrollo de planes de respuesta del nivel local. En particular, sobre el saneamiento ambiental como el principal problema del asentamiento que genera un riesgo potencial para la transmisión de diversas enfermedades infecciosas.

Abstract Introduction: An unreported phenomenon currently exists in Colombia, namely, massive emigration from Venezuela that is presenting a great challenge for Colombia's society and health system. Barranquilla is one of the principal recipient municipalities in northern Colombia. Venezuelan emigrants and returning Colombians are settling in this city's marginal zones, frequently under highly vulnerable environmental and social conditions. Objective: The present study is a brief exploration of the social and health needs in the Villa Caracas settlement. It is based on a semi-qualitative technique using free lists to explore the cultural domains associated with these needs. Presentation of Case: Villa Caracas is in southwestern Barranquilla, where roughly 100 Venezuelan families are believed to reside, in addition to returning and native Colombians who never relocated. While the inhabitants live in vulnerable conditions, the most important problems are not known. Methods: A total of 96 free lists were administered to inhabitants in Villa Caracas. Each subject was asked their sex, age, occupation, schooling, and migration status. The free lists included three questions: problems with the settlement, health problems, and where they go for medical care. Smith's salience index was calculated for each domain. Results: A total of 96 persons participated, 33 of which were men. The average age was 31.2 years (s.d. 9.6; range 18-65). Of the total sample, 82.3% were Venezuelan, 8.3% were returning Colombians, and 9.4% reported having dual nationality. All of the participating Venezuelans had an irregular migration status. The principal perceived social needs were: sewer systems (Smith´s salience Index (SSI): 0.38), drinking water (SSI: 0.31), and electricity (SSI: 0.30). With regard to health problems, those that stood out were acute respiratory infection (SSI: 0.39) and unspecified fever (SSI: 0.20). All of the inhabitants reported that they were not treated due to being Venezuelan. Conclusions: This approach made it possible to highlight the vulnerable conditions of the immigrants, serving as a starting point for a more in-depth diagnostic which will enable developing a local response plan, especially with regard to environmental sanitation since this was the principal problem in the settlement and it poses a potential risk for the transmission of various infectious diseases.

Health-Related quality of life of an adult population sample in Barranquilla, Colombia / Calidad de vida relacionada con salud en una muestra de población adulta en Barranquilla, Colombia

ABSTRACT Objective The aim of this study was to estimate values of health-related quality of life (HRQOL) by focusing on the physical and mental health of an adult population sample in the city of Barranquilla, Colombia. Materials and methods Cross-sectional study with 368 adults representing an adult population. The questionnaires included the health-related quality of life "CDC-Healthy Days", the Zung Self-Rating Depression Scale, and the Overall Disability Sum Score. The prevalence of fair or poor health status (FPH), frequent physical distress (FPD), frequent mental distress (FMD), and frequent activity limitation (FAL) was estimated according to socio-demographic characteristics, presence of depression, and physical disability. Results The mean age of 368 adults was 45.6 ± 18.3 years; 55.7% were males. Only 21% of this population considered their general health to be fair or poor. The prevalence of FPH, FPD, FMD and FAL was higher in women than in men, and increased with greater severity of depression and higher physical disability. Moreover, 12% of the population presented with mild depression, 3.8% with moderate depression, and less than 1% with severe depression. 94% of this population did not have an arms or legs disability. Discussion This study provides HRQOL values for an adult sample of the population of Barranquilla, Colombia. Overall, the HRQOL of this population, with subtle differences, is similar to other reports from Colombia. In general, women and people with depression and physical disabilities had a worse quality of life.(AU)

RESUMEN Objetivo Estimar los valores de la calidad de vida relacionada con la salud (CVRS) enfocados en la salud física y mental de una muestra de población adulta en la ciudad de Barranquilla, Colombia. Métodos Estudio transversal, con 368 adultos. Los cuestionarios consistían en escala de calidad de vida relacionada con la salud "CDC-Healthy Days", la Escala de Depresión de Zung y el Puntaje General de la Discapacidad. La prevalencia del estado de salud regular o deficiente (FPH), el estrés físico frecuente (FPD), el estrés mental frecuente (FMD) y la limitación de la actividad frecuente (FAL) se estimaron según las características sociodemográficas, la presencia de depresión y la discapacidad física. Resultados La edad promedio de los 368 adultos fue de 45.6 ± 18.3 años, 55.7% fueron hombres. El 21% de esta población consideraba que su salud general era justa o pobre. La prevalencia de FPH, FPD, FMD y FAL fue mayor en mujeres que en hombres; incrementó con mayor severidad de depresión y con mayor discapacidad física en esta población. El 12% tenía depresión leve, 3.8% tenía depresión moderada y menos del 1% depresión grave. El 94% de esta población no tenía una discapacidad de brazos o piernas. Discusión Este estudio proporciona valores de CVRS en una muestra adulta de la población de Barranquilla, Colombia. En general, la CVRS de esta población, con pequeñas diferencias, es similar a otros estudios de Colombia. En general, las mujeres, las personas con depresión y discapacidades físicas tenían una peor calidad de vida.(AU)