Validation of the Spanish translation Sheffield Profile for Assessment and Referral for Care (SPARC-Sp) at the Hospital Universitario San Jose of Popayan, Colombia.

OBJECTIVES: We determined the validity and reliability of the Spanish translation Sheffield Profile for Assessment and Referral for Care (SPARC-Sp) questionnaire to identify the palliative care (PC) needs of patients with chronic noncommunicable diseases (NCDs) in Colombia. METHODS: We developed a cross-sectional observational study of scale assessment in adults with the aim of determining the validity and reliability of the SPARC-Sp questionnaire to identify the PC needs of patients with NCDs receiving outpatient or inpatient care at the Hospital Universitario San Jose of Popayan - ESE, Colombia, from 2021 to 2022. RESULTS: We applied a questionnaire consisting of demographic, clinical data, and SPARC-Sp to 507 participants. The constructed model explained 75% of the variance with an adequate fit according to the root mean square residual (0.03), the comparative fit index (0.98), and acceptable reliability (McDonald's total omega 0.4-0.9). Opportunities for improvement are the reformulation and inclusion of particular words to improve the representativeness and clarity of the domains of communication and information, religious, and spiritual issues. SIGNIFICANCE OF RESULTS: This research represents the first validation of SPARC in Spanish. SPARC-Sp is an instrument that allows initiating a conversation of the patient's main needs through a systematic assessment of the patients' main needs. Its psychometric validation demonstrated good fit and acceptable reliability.

Samples in randomized clinical trials with interim analysis. / La muestra en ensayos clínicos aleatorizados con análisis interino.

OBJECTIVES.: This article introduces randomized clinical trials and basic concepts of statistical inference. We present methods for calculating the sample size by outcome type and the hypothesis to be tested, together with the code in the R programming language. We describe four methods for adjusting the original sample size for interim analyses. We sought to introduce these topics in a simple and concrete way, considering the mathematical expressions that support the results and their implementation in available statistical programs; therefore, bringing health students closer to statistics and the use of statistical programs, which are aspects that are rarely considered during their training.

Mental health problems and resilience in adolescents during the COVID-19 pandemic in a post-armed conflict area in Colombia.

The impact of COVID-19 pandemic on mental health of adolescents are emerging and require particular attention in settings where challenges like armed conflict, poverty and internal displacement have previously affected their mental wellbeing. This study aimed to determine the prevalence of anxiety symptoms, depressive symptomatology, probable post-traumatic stress disorder and resilience in school-attending adolescents in a post-conflict area of Tolima, Colombia during the COVID-19. A cross-sectional study was carried out with 657 adolescents from 12 to 18 years old, recruited by convenience sampling in 8 public schools in the south of Tolima, Colombia, who completed a self-administered questionnaire. Mental health information was obtained through screening scales for anxiety symptoms (GAD-7), depressive symptomatology (PHQ-8), probable post-traumatic stress disorder (PCL-5) and resilience (CD-RISC-25). The prevalence observed for moderate to severe anxiety symptoms was 18.9% (95% CI 16.0-22.1) and for moderate to severe depressive symptomatology was 30.0% (95% CI 26.5-33.7). A prevalence of probable post-traumatic stress disorder (PTSD) of 22.3% (95% CI 18.1-27.2) was found. The CD-RISC-25 results for resilience had a median score of 54 [IQR 30]. These results suggest that approximately two-thirds of school-attending adolescents in this post-conflict area experienced at least one mental health problem such as anxiety symptoms, depressive symptomatology or probable PTSD during the COVID-19 pandemic. Future studies are of interest to establish the causal relationship between these findings and the impact of the pandemic. These findings highlight the challenge that schools have after pandemic to address the mental health of their students in order to promoting adequate coping strategies and implement prompt multidisciplinary interventions to reduce the burden of mental health problems in adolescents.

Development and Implementation of DIALOG+S in the School Setting as a Tool for Promoting Adolescent Mental Well-Being and Resilience in a Post-Armed Conflict Area in Colombia: Exploratory Cluster Randomized Controlled Trial.

BACKGROUND: Educational settings are ideal for promoting mental well-being and resilience in children. The challenges of the COVID-19 pandemic made evident the important role that teachers and school counselors play in the mental health of their students. Therefore, it is imperative to develop and implement cost-effective interventions that allow them to identify and address mental health problems early, especially in post-armed conflict areas, to reduce the burden of mental disorders in this population. OBJECTIVE: This study aimed to adapt an existing patient-focused digital intervention called DIALOG+ from an adult clinical setting to an adolescent educational setting and to assess the feasibility, acceptability, and estimated effect of implementing this intervention as a tool for promoting quality of life, mental well-being, and resilience. METHODS: We conducted an exploratory mixed methods study in 2 public schools in postconflict areas in Tolima, Colombia. This study was conducted in 3 phases. In the adaptation phase, focus groups were conducted with students and teachers to identify changes required in DIALOG+ for it to be used in the school setting. The exploration phase consisted of an exploratory cluster randomized controlled trial. A total of 14 clusters, each with 1 teacher and 5 students, were randomly allocated to either the experimental (DIALOG+S) group or to an active control group (counseling as usual). Teachers in both groups delivered the intervention once a month for 6 months. Through screening scales, information was collected on mental health symptoms, quality of life, self-esteem, resilience, and family functionality before and after the intervention. Finally, the consolidation phase explored the experiences of teachers and students with DIALOG+S using focus group discussions. RESULTS: The changes suggested by participants in the adaptation phase highlighted the central importance of the school setting in the mental health of adolescents. In the exploratory phase, 70 participants with a mean age of 14.69 (SD 2.13) years were included. Changes observed in the screening scale scores of the intervention group suggest that the DIALOG+S intervention has the potential to improve aspects of mental health, especially quality of life, resilience, and emotional symptoms. The consolidation phase showed that stakeholders felt that using this intervention in the school setting was feasible, acceptable, and an enriching experience that generated changes in the perceived mental health and behavior of participants. CONCLUSIONS: Our results are encouraging and show that the DIALOG+S intervention is feasible and acceptable as a promising opportunity to promote well-being and prevent and identify mental health problems in the school context in a postconflict area in Colombia. Larger, fully powered studies are warranted to properly assess the efficacy and potential impact of the intervention and to refine implementation plans. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN) registry ISRCTN14396374; https://www.isrctn.com/ISRCTN14396374. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/40286.

Psychodermatologic pathology in adolescents: findings from the Colombian National Mental Health Survey.

BACKGROUND: Associations between mental health and dermatology have generated a new branch of study called psychodermatology, which includes relevant conditions to the adolescent population. However, there is limited research focusing on this field and this specific population. OBJECTIVE: To estimate the prevalence of dermatological pathologies in the Colombian adolescent population and their possible associations with mental health conditions. METHODS: We performed a secondary analysis of the Colombian National Mental Health Survey results. A representative sample of the adolescent Colombian population answered questions regarding dermatological conditions and mental health disorders. We estimated the prevalence and evaluated associations using the chi squared independence test. RESULTS: Of 1753 adolescents, 8.3% (CI95%=[6.8-10.1]) had dermatitis or skin allergies and 4.5% (CI95%=[3.3-6.1]) acne. For dermatitis, we found associations with age, education, and family dysfunction (p-Values=0.024; <0.001; 0.046 respectively). Acne was associated with age, sex, educational level, the number of social groups involved in, alcohol consumption, psychoactive substances use and previous violent experiences (respective p-Values=0.007; 0.004; 0.005; 0.036; 0.002; 0.003; 0.044). Regarding mental health, dermatological conditions were associated with depression, affective disorders, suicide attempt and suicide ideation. CONCLUSION: Our results are the first to describe the prevalence of these disorders in Colombia. This is an exploratory study; nonetheless, it is of great value since it is the first to describe these associations in adolescents in a middle-income country, which should be considered during clinical examinations. Further longitudinal studies evaluating possible causal relationship between psychiatric and dermatological conditions are fundamental to establish causal links.

Mental health in adolescents displaced by the armed conflict: findings from the Colombian national mental health survey.

BACKGROUND: Colombia has one of the largest populations of internally displaced individuals by an armed conflict. However, there is no data demonstrating its effect on health, particularly in adolescents. PURPOSE: To describe the prevalence and associations of mental illness in the adolescent population displaced by violence in Colombia. METHODS: We conducted a secondary analysis of the 2015 National Mental Health Survey (NMHS), which provides data of mental health issues (SRQ), mental health disorders (CIDI-CAPI) and sociodemographic characteristics. RESULTS: Of the 1754 adolescents interviewed 5.3% (95% CI 4.1 to 6.9) mentioned a change in residence due to violence. Among them 38.5% lived in poverty compared to 23.6% of those non-displaced by the conflict. Suicidal thoughts and suicide attempt were present in 19.8% and 9.1% of displaced adolescents respectively, compared to 5.8% and 2.1% of non-displaced adolescents. The prevalence of post-traumatic stress disorder (PTSD) and any mental health disorder (measured with the CIDI-CAPI) was higher in the displaced population 12.3%, 11% respectively, in contrast to 2.1% and 7% of those non-displaced. Finally, anxiety and depressive disorders were more common among displaced adolescents. CONCLUSION: A higher prevalence of mental health conditions and disorders is observed among displaced adolescents.

Epidemiological measures: application and interpretation in real-life scenarios according to epidemiological study designs

Frequency, association and impact measures are key concepts in clinical epidemiology; however, it has been found that a considerable proportion of health students and professionals have no knowledge of how to use or interpret them when reading a scientific paper or conducting research. This article aims to explain the main epidemiological measures, how they are used, derived and interpreted. They are approached from the perspective of each of the most frequently used types of primary quantitative research studies (randomized clinical trials, cohort studies, case-control estudies and cross-sectional studies) in order to provide the reader with the context in which they are used. Moreover, the process for calculating and interpreting each result in a real setting is explained using clinical examples for a better understanding of these concepts and in order to prevent their use from becoming just a mechanical or repetitive exercise.

Las medidas de frecuencia, asociación e impacto son conceptos fundamentales de la epidemiología clínica; sin embargo, se ha encontrado que una parte considerable de los estudiantes y de los profesionales en el área de la salud no sabe cómo usarlas ni cómo interpretarlas al leer un texto científico o al hacer una investigación. Este artículo busca explicar las principales medidas epidemiológicas, cuándo se usan, cómo se obtienen y cómo se interpretan. Se abordan desde cada tipo de estudios primarios más frecuentemente utilizados cuando se realizan investigaciones cuantitativas (ensayos clínicos aleatorizados, estudios de cohorte, casos y controles y estudios de corte transversal), con el fin de darle al lector el contexto en el cual se usan. Además, mediante ejemplos clínicos, se explica el proceso para calcular e interpretar cada resultado en un escenario real, con el fin de lograr una mayor comprensión de estos conceptos y de que su uso no sea un ejercicio mecánico o de repetición.

La muestra en ensayos clínicos aleatorizados con análisis interino / Samples in randomized clinical trials with interim analysis

RESUMEN En este artículo se introducen los ensayos clínicos aleatorizados y conceptos básicos de la inferencia estadística. Se presenta como calcular el tamaño de muestra por tipo de desenlace e hipótesis a probar, junto con el código en el lenguaje de programación R para realizar su aplicación. Se presentan cuatro métodos para realizar el ajuste del tamaño de muestra original, cuando se planean análisis interinos. De una manera sencilla y concreta se busca realizar una introducción a estos temas, considerando las expresiones matemáticas que soportan los resultados y su implementación en programas estadísticos disponibles. Con el fin de acercar a los estudiantes de áreas de la salud a la estadística y al uso de programas estadísticos, aspectos poco considerados en su formación.

ABSTRACT This article introduces randomized clinical trials and basic concepts of statistical inference. We present methods for calculating the sample size by outcome type and the hypothesis to be tested, together with the code in the R programming language. We describe four methods for adjusting the original sample size for interim analyses. We sought to introduce these topics in a simple and concrete way, considering the mathematical expressions that support the results and their implementation in available statistical programs; therefore, bringing health students closer to statistics and the use of statistical programs, which are aspects that are rarely considered during their training.

[Mental Problems, Mood and Anxiety Disorders in The Population Displaced by Violence in Colombia; Results of The National Mental Health Survey 2015]. / Problemas mentales, trastornos del afecto y de ansiedad en la población desplazada por la violencia en Colombia, resultados de la Encuesta Nacional de Salud Mental 2015.

INTRODUCTION: Colombia has a large population exposed to violence. Our data suggest a significant number displaced by the conflict. As there is an increased risk of vulnerability, their problems and mental disorders need to be assessed in order to determine specific treatments. OBJECTIVES: To determine the prevalence of problems and mental disorders in those internally displaced by the conflict. METHODS: Data was obtained from the National Mental Health Survey 2015. The diagnostic tools used were the composite international diagnosis interview (CIDI-CAPI), Self-reporting questionnaire (SQR). Alcohol consumption was assessed with the Alcohol Use Disorders Identification test (AUDIT). A survey based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed. The modified Post-traumatic Stress Disorder (PTSD) Checklist-Civilian version (PCL-C) was used to determine possible post-traumatic stress Disorder. Multidimensional poverty index (MPI) and Family-Apgar questionnaire were applied to general individual and household data. RESULTS: A total of 943 persons displaced by the conflict were reported, with self-report of symptoms in 16.4% (95% CI, 13.2-20.1). The prevalence of any of the measured mental disorders (CIDI-CAPI) ever in life was 15.9% (95% CI, 11.9-21.1), with a suicidal ideation of 12.5% (95%CI, 9.0-17.1), and excessive alcohol consumption in 10.1% (95% CI, 7.2-13.9). More than one-third (35.6%, (95% CI, 30.7-40.8) of people report having experienced, witnessed, or been told that someone close had had a traumatic event related to the armed conflict. An increased risk of PTSD is reported by 3.6% (95% CI, 2.2-5.9) displaced people that had reported at least one traumatic event. Family dysfunction in the displaced population is absent (74.8% (95%.CI, 70.4-78.8). CONCLUSIONS: The displaced population has a high prevalence of problems and mental disorders, which confirms their disadvantaged situation.

Association of early childhood caries with risk factors in community homes of Instituto Colombiano de Bienestar Familiar in Zipaquirá, Colombia / Asociación de caries de infancia temprana con factores de riesgo en hogares comunitarios del Instituto Colombiano de Bienestar Familiar en Zipaquirá, Colombia

ABSTRACT Introduction: the goal of this study was to establish the association of social and biological risk factors with early childhood caries (ECC) in children from community homes of Instituto Colombiano de Bienestar Familiar (ICBF) in Zipaquirá, Colombia. Methods: descriptive cross-sectional study conducted by universities in 546 children aged 24 to 60 months. The following conditions were identified: socio-demographic variables, hygiene habits, O'Leary index and DMFT index, anthropometric variables, and psychomotor development. To evaluate the association of early childhood caries and severe caries to the variables under study, the Pearson's Chi-squared test was used for categorical variables, and the Spearman's correlation coefficient test was used for ordinal variables. Results: prevalence of ECC of 64.3% (95% CI 60.3%-68,3%) and severe ECC of 54% (95% CI 49.8%-58,2%). There was statistically significant association between the presence of ECC and inadequate brushing, visits to the dentist, dental treatment, the presence of malnutrition and the consumption of food at night after brushing; and severe ECC was associated with visits to the dentist, dental treatment, bottle feeding during the evening, the use of sweeteners in baby bottles, the habit of sleeping with the bottle, and food intake in the evening after brushing. Conclusions: the prevalence of EEC is high. The results of this study help validate the need for a comprehensive approach to children's health care, incorporating ECC to the spectrum of childhood diseases prevalent in the studied population.

RESUMEN. Introducción: el objetivo del presente estudio consistió en determinar la asociación de factores de riesgo sociales y biológicos con caries de infancia temprana (CIT) en los niños de hogares comunitarios del Instituto Colombiano de Bienestar Familiar (ICBF) en Zipaquirá, Colombia. Métodos: estudio descriptivo transversal, desarrollado por instituciones universitarias en 546 niños con edades entre los 24 y 60 meses. Se identificaron variables sociodemográficas, hábitos de higiene, los índices O'Leary y CEO, y variables antropométricas y de desarrollo psicomotriz. Para evaluar la asociación de caries de infancia temprana y caries severa con las variables evaluadas se aplicó la prueba χ² de Pearson en el caso de variables categóricas, y el coeficiente de correlación de rangos de Spearman en el caso de variables ordinales. Resultados: prevalencia de CIT del 64,3% (IC 95% 60,3%-68,3%) y de CIT severa del 54% (IC 95% 49,8%-58,2%). Se encontró asociación estadísticamente significativa entre la presencia de CIT y el cepillado inadecuado, la visita al odontólogo, el tratamiento odontológico, la presencia de desnutrición y el consumo de alimentos en la noche después de cepillarse; y de CIT severa con la visita al odontólogo, el tratamiento odontológico, la succión de biberón en la noche, el uso de endulzantes en el biberón, la costumbre de dormir con el biberón y el consumo de alimentos en la noche después de cepillarse. Conclusiones: la prevalencia de CIT es alta. Los resultados de este trabajo permiten evidenciar la necesidad de ofrecer un abordaje integral al cuidado de la salud de la infancia, incorporando la CIT al espectro de las enfermedades prevalentes de la infancia en la población estudiada.

The Rise of Colombian Biomedical Publications / Ascenso de las publicaciones biomédicas colombianas

In 1998, the Colombia Médica journal published an article describing the poor presence of Colombia in the context of Latin American biomedical publications1. Journals of the region were then reducing their share in the total number of publications indexed in MEDLINE. According to this study, in 1966, 2.03% of all references (3536 out of a total of 174 553) in this database came from journals edited in Latin American countries. In 1976 the percentage was 1.04% (2553 references out of 24 616), and dropped further to 0.81% in 1986 (2609 of 320 511) and even more in 1996, to 0.39% (1375 of 356 740). At that time, Colombia did not have any PubMed indexed journals. The situation, however, has changed in the past decade. Now we have five journals indexed in the database of the National Library of Medicine (Biomédica, Colombia Médica, Investigación y Educación en Enfermería, Revista de Salud Pública, and Revista Colombiana de Psiquiatría), and Colombian participation in international journals has grown significantly.

En 1998, la revista Colombia Médica publicó un artículo describiendo la escasa presencia de Colombia en el contexto de las publicaciones biomédicas latinoamericanas1. Las revistas de la región estaban reduciendo su participación en el número total de publicaciones indexadas en MEDLINE. Según este estudio, en 1966, el 2,03% de todas las referencias (3536 de un total de 174 553) en esta base de datos procedían de revistas editadas en países de América Latina. En 1976, el porcentaje era del 1,04% (2553 referencias de 24 616), y descendió hasta el 0,81% en 1986 (2609 de 320 511) e incluso más en 1996, hasta el 0,39% (1375 de 356740). En ese momento, Colombia no tenía revistas indexadas en PubMed. Sin embargo, la situación ha cambiado en la última década. Ahora tenemos cinco revistas indexadas en la base de datos de la Biblioteca Nacional de Medicina (Biomédica, Colombia Médica, Investigación y Educación en Enfermería, Revista de Salud Pública y Revista Colombiana de Psiquiatría), y la participación colombiana en revistas internacionales ha crecido significativamente.

Problemas mentales, trastornos del afecto y de ansiedad en la población desplazada por la violencia en Colombia, resultados de la Encuesta Nacional de Salud Mental 2015 / Mental Problems, Mood and Anxiety Disorders in The Population Displaced by Violence in Colombia; Results of The National Mental Health Survey 2015

Resumen Introducción: Colombia tiene una gran población expuesta a la violencia, con una cifra importante de desplazados por esta, quienes se encuentran en mayor riesgo de vulnerabilidad, por lo que es necesario evaluar en ellos problemas y trastornos mentales para definir intervenciones específicas necesarias. Objetivos: Determinar la prevalencia de problemas y trastornos mentales de la población colombiana desplazada por el conflicto armado interno. Métodos: Datos emanados de la Encuesta Nacional de Salud Mental 2015. Se realizó la entrevista diagnóstica internacional compuesta (CIDI-CAPI) y el Cuestionario de Síntomas (SRQ) como indicador de posible enfermedad psiquiátrica; el consumo de alcohol se evaluó con el test de identificación de trastornos por consumo de alcohol (AUDIT); se diseñó una encuesta basada en la Prueba de Detección de Consumo de Alcohol, Tabaco y Sustancias (ASSIST); se modificó la Lista de Chequeo de Estrés Postraumático (PCL-C) para determinar posible estrés postraumático y se aplicó el Índice Multidimensional de Pobreza (IPM) y el APGAR familiar a los datos generales del individuo y del hogar. Resultados: Se detectó a 943 personas desplazadas por la violencia. Se presenta SQR positivo en el 16,4% (intervalo de confianza del 95% [IC95%], 13,2%-20,1%); la prevalencia de cualquiera de los trastornos mentales medidos (CIDI-CAPI) alguna vez en la vida es del 15,9% (IC95%, 11,9%-21,1%); la de ideación suicida es del 12,5% (IC95%, 9,0%-17,1%); la de consumo de alcohol excesivo, del 10,1% (IC95%, 7,2%-13,9%); el 35,6% (IC95%, 30,7%-40,8%) de las personas reportan que han vivido o presenciado o les han contado que alguien cercano ha tenido un evento traumático relacionado con el conflicto armado; se reporta un mayor riesgo de estrés postraumático en personas desplazadas que han reportado por lo menos un evento traumático (3,6%; IC95%, 2,2%-5,9%); la disfunción familiar en desplazados es ausente (74,8%; IC95%, 70,4%-78,8%). Conclusiones: La población desplazada tiene una alta prevalencia de problemas y trastornos mentales, lo que ratifica la situación de desventaja en que se encuentran

Abstract Introduction: Colombia has a large population exposed to violence. Our data suggest a significant number displaced by the conflict. As there is an increased risk of vulnerability, their problems and mental disorders need to be assessed in order to determine specific treatments. Objectives: To determine the prevalence of problems and mental disorders in those internally displaced by the conflict. Methods: Data was obtained from the National Mental Health Survey 2015. The diagnostic tools used were the composite international diagnosis interview (CIDI-CAPI), Self-reporting questionnaire (SQR). Alcohol consumption was assessed with the Alcohol Use Disorders Identification test (AUDIT). A survey based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed. The modified Post-traumatic Stress Disorder (PTSD) Checklist-Civilian version (PCL-C) was used to determine possible post-traumatic stress Disorder. Multidimensional poverty index (MPI) and Family-Apgar questionnairewere applied to general individual and household data. Results: A total of 943 persons displaced by the conflict were reported, with self-report of symptoms in 16.4 (95% CI, 13.2-20.1). The prevalence of any of the measured mental disorders (CIDI-CAPI) ever in life was 15.9% (95% CI, 11.9-21.1), with a suicidal ideation of 12.5% (95%CI, 9.0-17.1), and excessive alcohol consumption in 10.1% (95% CI, 7.2-13.9). More than one-third (35.6%, (95% CI, 30.7-40.8) of people report having experienced, witnessed, or been told that someone close had had a traumatic event related to the armed conflict. An increased risk of PTSD is reported by 3.6% (95% CI, 2.2-5.9) displaced people that had reported at least one traumatic event. Family dysfunction in the displaced population is absent (74.8% (95%.CI, 70.4-78.8). Conclusions: The displaced population has a high prevalence of problems and mental disorders, which confirms their disadvantaged situation.

Falso o verdadero: es esa la pregunta? / True or false: is that the question? / Falso ou verdadeiro, é essa a pergunta?

Objetivos: en los exámenes para estudiantes de medicina se emplean preguntas objetivas de la modalidad Falso o Verdadero (F/V), que solo tienen dos opciones de respuesta con alta probabilidad de ser contestadas correctamente por azar. El propósito de este trabajo fue demostrar que solicitar la argumentación de las respuestas disminuye el número de las correctas mejorando la capacidad de las preguntas para verificar los aprendizajes. Métodos: se revisaron 8.188 preguntas de F/V que requirieron sustentación de la respuesta, aplicadas en 28 evaluaciones de Patología de la carrera de Medicina de la Universidad de la Sabana durante cuatro semestres. Las respuestas se clasificaron en correctas e incorrectas y las sustentaciones, en correctas, parcialmente correctas o incorrectas. Se calculó el coeficiente de concordancia kappa entre las preguntas F/V y las preguntas F/V con sustentación, así como por período y por evaluación. Resultados: de un total de 8.188 preguntas, 6.112 (74,6%) fueron contestadas correctamente, 3.655 (44,6%) tuvieron sustentación correcta y 2.336 (28,5%) no fueron bien sustentadas, con un índice de concordancia global de 0,378 e índices bajos de concordancia por período. Conclusión: las preguntas de F/V pueden acompañarse de una sustentación que argumente la respuesta con el objetivo de reducir la probabilidad de responder simplemente por azar, desarrollar procesos cognitivos superiores y competencias comunicativas.

Objectives: Standard tests designed for medical students frequently include objective True/ False (T/F) questions, in which there are only two possible answers that can be successfully reached at random. The purpose of this work was to demonstrate that asking for support of the answers diminishes the number of randomly correct ones, so improving the ability of questions to verify learnings. Methods: 8.188 T/F questions whose answers had to be supported; they were applied in 28 written tests of Pathology, at the undergraduate medical program (La Sabana University, Chía, Colombia). Answers were classified as correct or incorrect, and their support, as correct, partially correct and incorrect. In order to analyze the data, the kappa agreement coefficient between T/F questions and T/F questions with support was calculated, as well as per term and per test. Results: Out of 8.188 T/F questions, 6.112 (74.6%) were correctly answered as true or false, 3.655 (44.6%) had a correct support, and 2.336 (28.5%) were not correctly supported, exhibiting a global agreement index of 0.378 and low agreement indexes per term. Conclusion: T/F questions could be accompanied by support of the answers in order to reduce the probability of randomly correct ones, to enhance the development of superior cognitive processes, and communicative essential competences.

Objetivos: nos exames para estudantes de medicina se empregam perguntas objetivas da modalidade Falso ou Verdadeiro (F/V), que só têm duas opções de resposta com alta probabilidade de ser contestadas corretamente por casualidade. O propósito deste trabalho foi demonstrar que solicitar a argumentação das respostas diminui o número das corretas melhorando a capacidade das perguntas para verificar as aprendizagens. Métodos: revisaram-se 8.188 perguntas de F/V que requereram sustentação da resposta, aplicadas em 28 avaliações de Patologia da carreira de Medicina da Universidade da Sabana durante quatro semestres. As respostas se classificaram em corretas e incorretas e as sustentações, em corretas, parcialmente corretas ou incorretas. Calculou-se o coeficiente de concordância kappa entre as perguntas F/V e as perguntas F/V com sustentação, bem como por período e por avaliação. Resultados: de um total de 8.188 perguntas, 6.112 (74,6%) foram respondidas corretamente, 3.655 (44,6%) tiveram sustentação correta e 2.336 (28,5%) não foram bem sustentadas, com um índice de concordância global de 0,378 e índices baixos de concordância por período. Conclusão: as perguntas de F/V podem acompanhar-se de uma sustentação que argumente a resposta com o objetivo de reduzir a probabilidade de responder simplesmente por casualidade, desenvolver processos cognitivos superiores e concorrências comunicativas.

Descripción del manejo de la información en la primera infancia en dieciséis municipios colombianos / Description of Information Management in Early Childhood in Sixteen Colombian Municipalities / Descriçã o do manuseio da informação na primeira infância em dezesseis municipios colombianos

Los objetivos de este trabajo fueron identificar los temas de mayor interés, las principales necesidades de información y los aspectos o sugerencias para la construcción de un sistema de información sobre el cuidado de la salud de la población infantil en los municipios. Se realizaron siete talleres en siete municipios, con la participación de 71 representantes de 19 entidades relacionadas con el cuidado de la salud de la población infantil. Se encontró que la falta de articulación, unificación y consolidación de la información ocasiona que la toma de decisiones se realice a partir de resultados desactualizados, incompletos o inexistentes. Por tanto, en los territorios se necesita un espacio donde se presente un panorama completo de la población infantil, articulando las diferentes instituciones y consolidando periódicamente los temas de interés.

The objectives of this work were to identify the most important topics, the main information needs and the aspects or suggestions for the construction of an information system regarding health care of child population in the municipalities. We carried out seven workshops in seven municipalities, with the participation of 71 representatives from 19 entities related to the health care of child population. We found that the lack of coordination, unification and consolidation of information causes decision taking to be performed based on outdated, incomplete or non-existent results. So, territories need a space to show the complete picture of the child population, to coordinate the different institutions and periodically consolidate topics of interest.

Os objetivos deste trabalho foram identificar os temas de maior interesse, as principais necessidades de informacao e os aspectos ou sugestoes para a construcao de um sistema de informacao sobre o cuidado da saúde da populacao infantil nos municipios. Realizaram-se sete oficinas em sete municipios, com a participacao de 71 representantes de 19 entidades relacionadas com o cuidado da saúde da populacao infantil. Encontrou-se que a falta de articulacao, unificacao e consolidacao da informacao ocasiona que a tomada de decisoes seja realizada a partir de resultados desatualizados, incompletos ou inexistentes. Por tanto, nos territórios é preciso um espaco onde apresentar um panorama completo da populacao infantil, articulando as diferentes instituicoes e consolidando periodicamente os temas de interesse.

Avances en la comprensión de la transición nutricional colombiana / Avanços na compreensão da transição nutricional colombiana / Advances in understanding Colombia´s nutrition transition

Objetivo: describir la presencia y las características relacionadas con la transición nutricional colombiana, a partir de datos antropométricos y sociodemográficos. Métodos: se estimó el estado nutricional de mujeres en edad fértil y niños menores de cinco años, con base en la información registrada en las bases de datos de la Encuesta Nacional de Demografía y Salud de Colombia delos años 1995, 2000, 2005 y 2010. Se evaluó la asociación entre el estado nutricional de los dos subgrupos y las características sociodemográficas, como también con marcadores potencialesde actividad física sedentaria. Resultados y conclusiones: se encontraron distintas expresionesde la transición nutricional en Colombia: mayor prevalencia de sobrepeso y obesidad en ambos subgrupos respecto a desnutrición, una prevalencia creciente y acelerada de obesidad en el grupo de mujeres en edad fértil, asociación del estado nutricional con marcadores potenciales de actividadfísica sedentaria y estado nutricional relacionado con algunas variables sociodemográficas...

Objective: to describe the presence and characteristics related to the Colombian nutrition transition by analyzing anthropometric and sociodemographic data. Methods: the nutritional conditionof women in childbearing age and of children under 5 years was estimated based on information from the Colombian 1995, 2000, 2005 and 2010 Demographic Health Surveys. Association between the nutritional condition of the two subgroups with sociodemographic characteristicsand potential markers of sedentary physical activity was evaluated. Results and Conclusions: different expressions of the nutritional transition in Colombia were observed: Higher prevalenceof overweight and obesity in both population subgroups as compared to undernutrition, an increasing and accelerated prevalence of obesity of women in childbearing age, associationof the nutritional condition with potential markers of sedentary physical activity in households and nutritional condition related to some sociodemographic variables...

Objetivo: Descrever a presencia e características relacionadas com a transição nutricional colombianaa partir de dados antropométricos e sociodemográficos. Métodos: Estimou-se o estado nutricional de mulheres em idade fértil e crianças menores de 5 anos com base na informação registrada nas bases de dados do Inquérito Nacional de Demografia e Saúde de Colômbia dos anos 1995, 2000, 2005 e 2010. Avaliou-se a associação entre estado nutricional dos dois subgrupos e características sociodemográficas mesmo com marcadores potenciais de atividade física sedentária. Resultados e conclusões: Encontraram-se diferentes expressões da transição nutricional na Colômbia: Maior prevalência de sobrepeso e obesidade em ambos os subgrupos respeito à desnutrição, prevalência crescente e acelerada de obesidade no grupo de mulheresem idade fértil, associação do estado nutricional com marcadores potenciais de atividade física sedentária e estado nutricional relacionado com variáveis sociodemográficas...