Epidemiological approaches to multivariable models of health inequity: A study of race, rurality, and occupation during the COVID-19 pandemic.

PURPOSE: Methods for assessing the structural mechanisms of health inequity are not well established. This study applies a phased approach to modeling racial, occupational, and rural disparities on the county level. METHODS: Rural counties with disparately high rates of COVID-19 incidence or mortality were randomly paired with in-state control counties with the same rural-urban continuum code. Analysis was restricted to the first six months of the pandemic to represent the baseline structural reserves for each county and reduce biases related to the disruption of these reserves over time. Conditional logistic regression was applied in two phases-first, to examine the demographic distribution of disparities and then, to examine the relationships between these disparities and county-level social and structural reserves. RESULTS: In over 200 rural county pairs (205 for incidence, 209 for mortality), disparities were associated with structural variables representing economic factors, healthcare infrastructure, and local industry. Modeling results were sensitive to assumptions about the relationships between race and other social and structural variables measured at the county level, particularly in models intended to reflect effect modification or mediation. CONCLUSIONS: Multivariable modeling of health disparities should reflect the social and structural mechanisms of inequity and anticipate interventions that can advance equity.

Prueba de ejercicio cardiopulmonar en militares colombianos con trauma torácico de guerra / Cardiopulmonary exercise test of Colombian military with war thoracic trauma

Introducción: Existen pocas publicaciones relacionadas con las pruebas de esfuerzo cardiopulmonar de soldados heridos en combate, y las diversas complicaciones que puede ocasionar el trauma de guerra. Objetivo: Describir las variables cardiopulmonares en soldados con trauma torácico de guerra, sometidos a pruebas de esfuerzo. Método: Se realizó un estudio descriptivo, entre los años 2010 - 2016, en el Hospital Militar Central de Bogotá, D.C., Colombia. La población de estudio estuvo constituida por 27 pacientes con antecedente de trauma torácico derivado de la guerra, quienes fueron sometidos a pruebas de esfuerzo cardiopulmonar. Se exploran las variables edad, sexo, síntomas, consumo de oxígeno, variables cardiopulmonares medidas por espirometría, tipo de cirugía, trauma y arma. Resultados: El consumo de oxígeno pico medio ml/min fue 2 891,8 (DE: 621,86), consumo de oxígeno pico mL/kg/min 43,25 (DS: 9,72), capacidad vital forzada prebroncodilatador (L) 4,5 (DS: 1, 3) y posbroncodilatador (L) 4,3 (DS: 1,01). El análisis exploratorio encontró diferencias significativas entre quienes tenían heridas por arma de fuego de alta velocidad, y heridas por otros tipos de armas. Conclusión: En pacientes con antecedentes de trauma de guerra, el consumo de oxígeno pico ml/min, oxígeno pico mL/kg/min y capacidad vital forzada, es menor que en población sana; aparentemente, el tipo de herida por arma de fuego de alta velocidad afecta en mayor medida a estas variables evaluadas por las pruebas de esfuerzo cardiopulmonar(AU)

Introduction: There are few publications related to cardiopulmonary stress tests in soldiers wounded in combat, and the various complications cause war trauma. Objective: To describe the cardiopulmonary variables in patients with war thoracic trauma submitted to stress tests. Methods: A descriptive study was carried out between 2010 and 2016, at the Hospital Militar Central de Bogotá, D.C., Colombia. The study population consisted of 27 patients with a history of war-derived thoracic trauma, who were submitted to cardiopulmonary stress tests. The variables of age, sex, symptoms, oxygen consumption, cardiopulmonary variables measured by spirometry, type of surgery, trauma and weapon were explored. Results: A total of 27 participants were included. Mean oxygen consumption peak ml / min was 2 891,8 (SD: 621,86), oxygen consumption peak mL/kg/min 43,25 (DS: 9,72), forced vital capacity pre-bronchodilator (L) 4,5 (DS: 1, 3) and post-bronchodilator (L) 4,3 (DS: 1,01). Exploratory analysis found significant differences among those who had a high velocity firearm wounds against other types of weapons. Conclusions: In patients with a history of trauma, peak oxygen consumption ml / min, peak oxygen mL/kg/min and forced vital capacity is lower than in the healthy population; Apparently, the type of high-velocity firearm wound has a greater effect on these variables evaluated by cardiopulmonary stress tests(AU)

Cloning and Molecular Characterization of an Alpha-Glucosidase (MalH) from the Halophilic Archaeon Haloquadratum walsbyi.

We report the heterologous expression and molecular characterization of the first extremely halophilic alpha-glucosidase (EC 3.2.1.20) from the archaeon Haloquadratum walsbyi. A 2349 bp region (Hqrw_2071) from the Hqr. walsbyi C23 annotated genome was PCR-amplified and the resulting amplicon ligated into plasmid pET28b(+), expressed in E. coli Rosetta cells, and the resulting protein purified by Ni-NTA affinity chromatography. The recombinant protein showed an estimated molecular mass of 87 kDa, consistent with the expected value of the annotated protein, and an optimal activity for the hydrolysis of α-PNPG was detected at 40 °C, and at pH 6.0. Enzyme activity values were the highest in the presence of 3 M NaCl or 3-4 M KCl. However, specific activity values were two-fold higher in the presence of 3-4 M KCl when compared to NaCl suggesting a cytoplasmic localization. Phylogenetic analyses, with respect to other alpha-glucosidases from members of the class Halobacteria, showed that the Hqr. walsbyi MalH was most similar (up to 41%) to alpha-glucosidases and alpha-xylosidases of Halorubrum. Moreover, computational analyses for the detection of functional domains, active and catalytic sites, as well as 3D structural predictions revealed a close relationship with an E. coli YicI-like alpha-xylosidase of the GH31 family. However, the purified enzyme did not show alpha-xylosidase activity. This narrower substrate range indicates a discrepancy with annotations from different databases and the possibility of specific substrate adaptations of halophilic glucosidases due to high salinity. To our knowledge, this is the first report on the characterization of an alpha-glucosidase from the halophilic Archaea, which could serve as a new model to gain insights into carbon metabolism in this understudied microbial group.

Percepción de sentido de vida en universitarios colombianos / Perception of the Meaning of Life among Colombian University Students / Percepção de sentido de vida em universitários colombianos

Objetivo. El presente trabajo propuso describir la percepción del sentido de vida de estudiantes universitarios colombianos de la ciudad de Bogotá, definida por Martínez (2007) como la percepción afectiva-cognitiva de valores que invitan a la persona a actuar de un modo u otro ante situaciones específicas o de la vida en general, dando coherencia e identidad personal. Se buscó caracterizar la percepción del sentido de vida según el área académica, el género y la edad de los participantes. Método. La muestra intencional estuvo compuesta por 695 estudiantes universitarios, de los cuales 68.9% eran mujeres y 31.1% hombres, con edad promedio de 22.17 años. Resultados. Mediante la aplicación de la Escala Dimensional del Sentido de Vida, no se encontraron diferencias significativas por género, sí se encontró que 36.7% de los participantes presentaron bajo sentido de vida, mientras que los estudiantes entre 16 y 20 años mostraron mayor sentido de vida. Los estudiantes de Medicina y Enfermería indicaron los mayores puntajes de sentido de vida; por su parte, los estudiantes de Psicología y Comunicación Social obtuvieron puntajes significativamente más bajos que el resto de participantes. Conclusión. Los resultados permiten obtener una primera aproximación general del sentido de vida de población joven colombiana, empleando un instrumento desarrollado y validado para el país. Además, se plantean nuevas preguntas investigativas con respecto a la salud mental de los estudiantes de psicología, en vista de su correlación con el sentido de vida reportada en otros estudios.

Objective. This study was undertaken to describe the perception of the meaning of life among university students in Bogotá, this being defined by Martínez as affective-cognitive perception of values that invite the person to act in one way or another to specific situations or life in general, giving coherence and personal identity. The objective was to characterize the perception of the meaning of life according to the academic area, gender and age of the participants. Method. The convenience sample consisted of 695 college students, of whom 68.9% were women (479) and 31.1% were men (216), with mean age of 22.17 years. Results. By applying the Dimensional Scale of Meaning of Life, there were no significant differences found by gender, 36.7% of participants showed a low meaning of life and students between 16 and 20 years showed a higher score of meaning of life. Medical and nursing students showed higher scores meaning of life, however, students of psychology and social communication had significantly lower scores than other participants. Conclusion. This work constitutes a first general approach in the Colombian population, with an instrument developed and validated for the country to characterize the meaning of life and raises new research questions regarding the mental health of students of psychology in view of its correlation with the meaning of life reported in other studies.

Escopo. O presente trabalho se propõe descrever a percepção do sentido de vida de estudantes universitários colombianos da cidade de Bogotá, definida por Martínez (2007) como a percepção afetiva-cognitiva de valores que invitam à pessoa a atuar de um modo ou outro ante situações específicas ou da vida em geral, dando coerência e identidade pessoal. Se procurou caracterizar a percepção do sentido de vida segundo a área acadêmica, o gênero e a idade dos participantes. Metodologia. A amostra intencional esteve composta por 695 estudantes universitários, dos quais 68.9% eram mulheres e 31.1 % homens, com idade de 22.17 anos de média. Resultados. Mediante a aplicação da Escada Dimensional do Sentido de Vida, não foram achadas diferencias significativas por gênero, foi achada que o 36.7% dos participantes apresentaram baixo sentido de vida. Os estudantes de Medicina e Enfermaria mostraram as maiores pontuações de sentido de vida, por sua parte, os estudantes de Psicología e Comunicação social presentaram pontuações significativamente mais baixos que o resto de participantes. Conclusão. Os resultados obtidos permitem ter uma primeira aproximação geral do sentido de vida de população jovem colombiana, empregando um instrumento desenvolvido e validado para o pais. Além, foram propostas novas questões investigativas com respeito à saúde mental dos estudantes de Psicología, em vista de sua correlação com o sentido de vida reportada em outros estudos.

A community health worker home visitation project to prevent neonatal deaths in Kenya.

Neonatal deaths account for 43% of under-5 childhood deaths in Kenya. Most infants are born at home, and many of them die at home unaccounted for, often during the first week of life. Previous studies in which community health workers (CHWs) were trained to provide neonatal care reported reductions in neonatal mortality. These programmes required more resources than may be available in some resource-poor settings. We implemented a brief and inexpensive programme to train rural Kenyan CHWs to evaluate newborn infants for signs of severe illness during the first week of life and refer the ill infants to a health facility. During the first 12 months, 20 CHWs visited 702 infants, and all three visits were completed for 93% of the infants. There were five neonatal deaths, none after the first week of life. A brief low-cost training programme for CHW home visitation of newborns is feasible for rural Kenya and the larger African setting.

[The effect of motivational interviews on young drinkers' autonomous motivation]. / Efectos de la entrevista motivacional sobre la motivación autónoma en jóvenes consumidores de alcohol.

OBJECTIVE: Assessing changes in autonomous and controlled motivation in a group of young at risk consumers and excessive alcohol consumers receiving motivational interviewing-based (MI) Intervention. METHODS: MI-based group intervention was put into practice to observe its effects on types of motivation. Two groups were formed (an experimental and a control group) using pretest-posttest design. 63 adolescents participated: 31 formed the experimental group (80 % male) and 32 the control group (68 % male). The treatment self-regulation questionnaire (TSRQ) was used to evaluate autonomous and controlled motivation. RESULTS: Analysis of variance revealed that autonomous motivation scores had no statistically significant change after the brief intervention, whereas this was so with controlled motivation (p<.05), suggesting that brief intervention had promoted this type of regulation towards moderate consumption expressed in terms of an external control, such as gaining social approval. CONCLUSION: The above results suggested that MI is a promising technique for intervention with Colombian adolescents as it had measurable positive effects on both types of motivation and motivational orientation toward control probably mediated the results. Individual motivational orientation and gender should be considered in the future.

Efectos de la entrevista motivacional sobre la motivación autónoma en jóvenes consumidores de alcohol / The effect of motivational interviews on young drinkers' autonomous motivation

Objetivo Evaluar los cambios en la motivación autónoma y controlada en un grupo de adolescentes consumidores en riesgo y consumidores excesivos de alcohol, que recibió una intervención basada en la Entrevista Motivacional (EM). Métodos Se implementó una intervención grupal basada en la EM para observar sus efectos sobre los tipos de motivación. Se conformaron dos grupos, un grupo experimental, y un grupo control en un diseño pretest-postest. Participaron en total 63 adolescentes, 31 conformaron el grupo experimental, (80 % hombres) y 32 el grupo control (68 % hombres). La motivación autónoma y la motivación controlada se evaluaron mediante el TSRQ. Resultado El análisis de varianza muestra que los puntajes de la motivación autónoma no presentaron cambios estadísticamente significativos después de la intervención, mientras que la motivación controlada sí los presentó (p<.05), sugiriendo que la intervención promovió este tipo de regulación hacia el consumo moderado, expresada en términos de controles externos, por ejemplo, la aprobación social. Conclusión Estos resultados sugieren que la EM es una técnica promisoria para la intervención con adolescentes colombianos ya que tiene efectos positivos cuantificables sobre los dos tipos de motivación y probablemente la orientación motivacional hacia el control medió los resultados. Es importante considerar en el futuro la orientación motivacional individual y el género.

Objective Assessing changes in autonomous and controlled motivation in a group of young at risk consumers and excessive alcohol consumers receiving motivational interviewing-based (MI) Intervention. Methods MI-based group intervention was put into practice to observe its effects on types of motivation. Two groups were formed (an experimental and a control group) using pretest-posttest design. 63 adolescents participated: 31 formed the experimental group (80 % male) and 32 the control group (68 % male). The treatment self-regulation questionnaire (TSRQ) was used to evaluate autonomous and controlled motivation. Results Analysis of variance revealed that autonomous motivation scores had no statistically significant change after the brief intervention, whereas this was so with controlled motivation (p<.05), suggesting that brief intervention had promoted this type of regulation towards moderate consumption expressed in terms of an external control, such as gaining social approval. Conclusion The above results suggested that MI is a promising technique for intervention with Colombian adolescents as it had measurable positive effects on both types of motivation and motivational orientation toward control probably mediated the results. Individual motivational orientation and gender should be considered in the future.