Circulating extracellular vesicles in Systemic Lupus Erythematosus: physicochemical properties and phenotype.

OBJECTIVE: This study aimed to identify the physicochemical and phenotypic characteristics of circulating Extracellular Vesicles (EVs) in the plasma of patients with SLE, with or without Lupus Nephritis (LN), and their potential utility as disease biomarkers. METHODS: Plasma-circulating EVs were concentrated using differential centrifugation from adult female patients (n=38) who met the 'American College of Rheumatology/European Alliance of Associations for Rheumatology 2019' criteria for SLE diagnosis with (LN) or without LN (nLN), confirmed by renal biopsy. Controls (n=18) were healthy volunteers matched by gender and similar age. The structure, size and Energy Dispersion Spectrum (EDS) of EVs were observed by electron microscopy. The surface charge and size distribution were evaluated using dynamic light scattering. The counts and phenotype of EVs from patients (SLE-EVs) and controls (Ctrl-EVs) were obtained using flow cytometry. Non-parametric statistical tests and exploratory analysis of multiple variables were performed. The discriminatory power of some variables as potential biomarkers of the disease was also evaluated. RESULTS: Circulating EVs were heterogeneous in morphology and size, but SLE-EVs reached larger diameters than Ctrl-EVs (p<0.0001). Small SLE-EVs and large SLE-EVs were increased compared with Ctrl-EV (p<0.0001 and p<0.05, respectively). Likewise, patients with SLE (LN or nLN) had higher concentrations of large EVs compared with controls (p<0.001 and p<0.0001, respectively). SLE-EVs showed a different EDS (p<0.001) and were less electronegative (p<0.0001) than Ctrl-EVs. EV-CD45+, EV-CD14+ and EV-IgM+ were more frequent in patients with SLE compared with controls (p<0.001, p<0.05 and p<0.001, respectively). The concentrations of large EVs and EV-IgM+ allowed better discrimination of patients from controls. CONCLUSIONS: Plasma-circulating EVs from patients with SLE with and without nephritis are increased in peripheral blood and have different physicochemical properties than controls. Characteristics of EVs such as larger size and the presence of IgM on the surface could help discriminate patients from controls.

Low-Temperature Synthesis of Bi2S3 Hierarchical Microstructures via Co-Precipitation and Digestive Process in Aqueous Medium.

Bismuth sulfide (Bi2S3) nanostructures have gained significant attention in the fields of catalysis, optoelectronics, and biomedicine due to their unique physicochemical properties. This paper introduces a simple and cost-effective method for producing Bi2S3 microstructures at low temperatures (25 and 70 °C). These microstructures are formed by the hierarchical self-assembly of Bi2S3 nanoparticles, which are typically 15-40 nm in size. The nanoparticles are synthesized by the co-precipitation of thioglycolic acid, thioacetamide, and bismuth nitrate in water. The study delves into the phase composition and morphological evolution of the microstructures, concerning the chemical composition of the solution and the synthesis temperature. X-ray analysis has confirmed the formation of single-phase bismuthinite Bi2S3. The synthesis process generates primary building blocks in the form of 15-40 nm Bi2S3 nanocrystals, which then go through a hierarchical self-assembly process to produce a range of micrometer-sized structures. A scanning electron microscopy examination revealed that the primary nanoparticles self-assemble into quasi-1D worm-like nanostructures, which then self-assemble to create sponge-shaped microstructures. These structures subsequently self-organize and refine into either flower- or dandelion-like microstructures, mostly depending on the synthesis temperature and the chemistry of the digestion medium.

Psychometric Testing of HeLD-14 in a Colombian Geriatric Population.

Introduction: The objective of this study was to test the validity and reliability of the Colombian version of the Health Literacy in Dentistry (HeLD-14) in older adults. Materials and Methods: A translation and validation study of HeLD-14 was conducted on 384 non-institutionalized older adults attending the Dental Clinic at Universidad Cooperativa from Pasto, Colombia. A cross-cultural adaptation of a multidimensional HeLD-14 was completed, and the psychometric properties of this scale were evaluated through a cross-validation method using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). Internal consistency was measured with Cronbach's alpha (α) and Omega's McDonald (É·). The statistical significance was set at P < 0.05. Results: The EFA demonstrated that a single-factor structure with 11 items explained a cumulative 59.86% of the overall variance. The CFA confirmed that goodness of fit indices of this questionnaire had optimal adequateness (χ2S-B = 109.047; χ2S-B/(44) = 2.478, P=0.001; non-normed fit index = 0.901; comparative fit index = 0.908; root mean square error of approximation = 0.079 (90% CI (0.075, 0.083)); standardized root mean residual = 0.080). The coefficients indicated a high internal consistency for the total scale (α = 0.94; É· = 0.96). Conclusion: The developed adaptation of HeLD-14 for the Colombian population, HeLD-Col, is a unidimensional, reliable, and valid instrument to assess oral health literacy in older adults in Colombia.

Oral Health Literacy and Tooth Loss and Replacement in Older Adults at a University Dental Clinic in Colombia.

BACKGROUND: Oral health literacy (OHL) is the ability of individuals to obtain, process, and understand oral health information and services, allowing them to make appropriate oral health decisions. The association between OHL and tooth loss and replacement have not been well understood. OBJECTIVES: We aimed to determine the association between OHL and tooth loss and replacement in a Colombia population. METHODS: A cross-sectional study of 384 older adults age 65 to 89 years from Pasto, Colombia was carried out. The number of lost and replaced teeth was assessed intraorally; sociodemographic and prosthetic characteristics were collected, and the Health Literacy in Dentistry questionnaire was used to evaluate OHL. Generalized linear models were estimated to assess associations between independent variables (including OHL) and the number of lost and replaced teeth. KEY RESULTS: There were 224 (58.3%) men and 160 (41.7%) women. The mean (standard deviation [SD]) number of lost and replaced teeth was 27.78 (4.03) and 12.53 (9.89), respectively. One hundred fifty five (40.4%) individuals had full removable dental protheses, 122 (31.8%) partial removable dental protheses, 68 (17.7%) fixed prosthetics, and 36 (9.4%) dental implants. OHL was 33.29 (6.59) and significantly positively associated with the number of replaced teeth (ß = 0.65, 95% confidence interval [CI]: 0.52-0.78, p < .001), but not with lost teeth. CONCLUSIONS: OHL may foster individuals' capabilities to replace lost teeth, although we did not find it associated with reduced tooth loss, likely as tooth loss was highly common in this older population. [HLRP: Health Literacy Research and Practice. 2024;8(1):e21-e28.].

PLAIN LANGUAGE SUMMARY: The association between OHL and tooth loss and replacement has not been well understood. A study of 384 older adults was designed to evaluate the number of lost and replaced teeth and the association with OHL. We found that OHL may foster tooth replacement but was not associated with tooth loss itself.

Janus kinase inhibitors modify the fatty acid profile of extracellular vesicles and modulate the immune response.

Background: Janus kinase inhibitors (jakinibs) are immunomodulators used for treating malignancies, autoimmune diseases, and immunodeficiencies. However, they induce adverse effects such as thrombosis, lymphocytosis, and neutropenia that could be mediated by extracellular vesicles (EVs). These particles are cell membrane-derived structures that transport cellular and environmental molecules and participate in intercellular communication. Jakinibs can modify the content of EVs and enable them to modulate the activity of different components of the immune response. Objective: to evaluate the interactions between immune system components of healthy individuals and EVs derived from monocytic and lymphoid lineage cells generated in the presence of baricitinib (BARI) and itacitinib (ITA) and their possible effects. Methods: EVs were isolated from monocytes (M) and lymphocytes (L) of healthy individuals, as well as from U937 (U) and Jurkat (J) cells exposed to non-cytotoxic concentrations of BARI, ITA, and dimethyl sulfoxide (DMSO; vehicle control). The binding to and engulfment of EVs by peripheral blood leukocytes of healthy individuals were analyzed by flow cytometry using CFSE-stained EVs and anti-CD45-PeCy7 mAb-labeled whole blood. The effect of EVs on respiratory burst, T-cell activation and proliferation, cytokine synthesis, and platelet aggregation was evaluated. Respiratory burst was assessed in PMA-stimulated neutrophils by the dihydrorhodamine (DHR) test and flow cytometry. T-cell activation and proliferation and cytokine production were assessed in CFSE-stained PBMC cultures stimulated with PHA; expression of the T-cell activation markers CD25 and CD69 and T-cell proliferation were analyzed by flow cytometry, and the cytokine levels were quantified in culture supernatants by Luminex assays. Platelet aggregation was analyzed in platelet-rich plasma (PRP) samples by light transmission aggregometry. The EVs' fatty acid (FA) profile was analyzed using methyl ester derivatization followed by gas chromatography. Results: ITA exposure during the generation of EVs modified the size of the EVs released; however, treatment with DMSO and BARI did not alter the size of EVs generated from U937 and Jurkat cells. Circulating neutrophils, lymphocytes, and monocytes showed a 2-fold greater tendency to internalize ITA-U-EVs than their respective DMSO control. The neutrophil respiratory burst was attenuated in greater extent by M-EVs than by L-EVs. Autologous ITA-M-EVs reduced T-cell proliferation by decreasing IL-2 levels and CD25 expression independently of CD69. A higher accumulation of pro-inflammatory cytokines was observed in PHA-stimulated PBMC cultures exposed to M-EVs than to L-EVs; this difference may be related to the higher myristate content of M-EVs. Platelet aggregation increased in the presence of ITA-L/M-EVs by a mechanism presumably dependent on the high arachidonic acid content of the vesicles. Conclusions: Cellular origin and jakinib exposure modify the FA profile of EVs, enabling them, in turn, to modulate neutrophil respiratory burst, T-cell proliferation, and platelet aggregation. The increased T-cell proliferation induced by BARI-L/M-EVs could explain the lymphocytosis observed in patients treated with BARI. The higher proportion of arachidonic acid in the FA content of ITA-L/M-EVs could be related to the thrombosis described in patients treated with ITA. EVs also induced a decrease in the respiratory burst of neutrophils.

Comparison of frailty determinants in Latin America: a national representative study in Brazil and Chile.

OBJECTIVE: This study aimed to compare the prevalence and socio-economic determinants of frailty in older adults in Brazil and Chile using nationally representative survey data. STUDY DESIGN: Analytical research using data from the Brazilian Longitudinal Study of Aging (ELSI) and the Chilean National Health Survey (ENS) conducted in Brazil and Chile between 2015 and 2017. METHODS: The study included 5484 older adults aged 60 years or older in Brazil and 2031 in Chile. Frailty was measured using the FRAIL index, and logistic regression models were used to identify the determinants of frailty. RESULTS: The prevalence of frailty is 15.6% and 12.6% in Brazil and Chile, respectively. Frailty is associated with several factors, including age, sex, living alone, residing in urban areas, and decreased life satisfaction. However, the analysis revealed notable differences between countries. A greater number of significant variables were associated with frailty in Brazil, whereas Chile displayed fewer categories with significant odds. Health insurance had no significant effect in either of the two countries. CONCLUSIONS: The limitations in data sources and methodologies make it challenging to compare frailty determinants in Latin America. This study overcomes these barriers and shows that, even within the same region, significant differences exist. Levels and characteristics that are important in one country may not be so in another. The results emphasize the need to consider contextual factors in the implementation of emerging social and healthcare policies, such as home-based long-term care.

Lippia origanoides Essential Oil or Thymol in Combination with Fluconazole Produces Damage to Cells and Reverses the Azole-Resistant Phenotype of a Candida tropicalis Strain.

Candida tropicalis is one of the most pathogenic species within the genus. Increased antifungal resistance has been reported, which is in part due to the organism's ability to form biofilms. In natural products derived from plants, such as essential oils (EOs) or their major components, there is significant potential to develop new antifungals or to both enhance the efficacy and reduce the toxicity of conventional antifungals. This study aimed to evaluate the effect of combining an EO of Lippia origanoides or thymol with fluconazole on an azole-resistant C. tropicalis strain. Synergism was observed in the combination of fluconazole with the EO and with thymol, and minimal inhibitory concentrations for fluconazole decreased at least 32-fold. As a consequence of the synergistic interactions, mitochondrial membrane potential was reduced, and mitochondrial superoxide production increased. Alteration in nuclear morphology, cell surface, and ultrastructure was also observed. In conclusion, the synergistic interaction between L. origanoides EO or thymol with fluconazole reverted the azole-resistant C. tropicalis phenotype. These findings suggest that L. origanoides EO or thymol alone, or in combination with fluconazole, have the potential for development as antifungal therapies for this yeast, including resistant strains.

Nanostructured PbSe Films Deposited by Spray Pyrolysis Using PbSe Colloidal Solutions.

This work describes the spray pyrolysis deposition of PbSe films, using as-prepared PbSe colloids as the starting solution. The PbSe colloids were prepared by using the alkahest approach, where Pb and Se precursors were made to react with the following green polyols: glycerin, ethylene glycol, and propylene glycol, to subsequently spray them onto glass substrates. The results of the characterization indicated that amine or thiol groups-free and single-phase rock-salt cubic PbSe powder was obtained, producing nanocrystals 16-30 nm in size. X-ray diffraction also showed that the PbSe films containing PbSeO3 and PbO·xH2O as impurity phases were produced during the deposition. The morphology of the powders and films was developed by a self-assembly process, in which the primary PbSe nanoparticles self-assemble to produce peanut-like microstructures. Additionally, a non-continuous and porous feature was formed in the thick films. Certain films revealed optical structures characterized by broad- and low-intensity bands resembling an exciton-like behavior. This could be attributed to the presence of nanocrystals with a size less than the Bohr radius, indicating reminiscent quantum effects. The results suggest that the usage of colloidal dispersions as spray solutions represents an effective approach to forming PbSe films, as well as that the synthesis method allows for the elimination of thiol and amine groups before deposition, significantly simplifying the process.

Impact Evaluation of Cash-For-Care in Latin America's New Long-Term Care Policies: A Randomized Controlled Trial Pilot Study in Costa Rica.

Latin America is aging rapidly. Thus, governments in the region are reformulating their social protection policies. In 2022, Costa Rica passed a national long-term care law. A discussion developed on how to provide such care, whether through public or private in-kind benefits or cash-for-care (CfC) to beneficiaries. CfC has been used in developed countries with various outcomes. However, there are still no evaluations of its effects in middle-income countries. The objective of this study was to evaluate the impact of CfC pilot study on female caregivers in a middle-income country. The expectations of the program were to find positive effects of CfC on caregivers. After conducting a literature review, we developed four domains of analysis: labor market participation, time for personal activities, use of CfC, and caregiver burnout. The results indicate that CfC has no significant impact on caregivers' integration into the labor market, or ability to have leisure time. However, there was a positive effect on the funding of basic needs and mitigation of factors predicting burnout.

In Vitro and In Vivo Efficacy of a Stroma-Targeted, Tumor Microenvironment Responsive Oncolytic Adenovirus in Different Preclinical Models of Cancer.

More than one million women are diagnosed annually worldwide with a gynecological cancer. Most gynecological cancers are diagnosed at a late stage, either because a lack of symptoms, such as in ovarian cancer or limited accessibility to primary prevention in low-resource countries, such as in cervical cancer. Here, we extend the studies of AR2011, a stroma-targeted and tumor microenvironment responsive oncolytic adenovirus (OAdV), whose replication is driven by a triple hybrid promoter. We show that AR2011 was able to replicate and lyse in vitro fresh explants obtained from human ovarian cancer, uterine cancer, and cervical cancer. AR2011 was also able to strongly inhibit the in vitro growth of ovarian malignant cells obtained from human ascites fluid. The virus could synergize in vitro with cisplatin even on ascites-derived cells obtained from patients heavily pretreated with neoadjuvant chemotherapy. AR2011(h404), a dual transcriptionally targeted derived virus armed with hCD40L and h41BBL under the regulation of the hTERT promoter, showed a strong efficacy in vivo both on subcutaneous and intraperitoneally established human ovarian cancer in nude mice. Preliminary studies in an immunocompetent murine tumor model showed that AR2011(m404) expressing the murine cytokines was able to induce an abscopal effect. The present studies suggest that AR2011(h404) is a likely candidate as a novel medicine for intraperitoneal disseminated ovarian cancer.

Resiliencia y violencia en el noviazgo: un estudio explicativo-predictivo e instrumental con adolescentes colombianos

Introducción: los estudios sobre resiliencia y violencia psicológica en parejas adolescentes en Colombia son escasos, pues se ha explorado con mayor frecuencia la violencia en parejas adultas; además, la disposición de óptimos instrumentos de medida de la violencia psicológica en el cortejo adolescente es limitada. Objetivos: analizar la influencia de la resiliencia en la violencia psicológica en parejas adolescentes; para ello, inicialmente se validó el Cuestionario de Violencia Psicológica en el Cortejo (PDV-Q). Método: el estudio es explicativo-predictivo y de tipo instrumental. La muestra incidental estuvo conformada por 700 adolescentes colombianos, con edades entre 15 a 20 años (M = 18.40; DT = 1.56; 29.3 % hombres). Se reconoció la confiabilidad, la validez de contenido y de constructo con análisis factoriales; posteriormente, se analizaron los modelos de ecuaciones estructurales (SEM). Resultados: se reconocieron evidencias adecuadas de validez y valores óptimos de confiabilidad del PDV-Q. El modelo SEM sugiere influencias inversas de la competencia personal sobre el rol de agresión y victimización; así como una influencia directa de la aceptación de uno mismo y la vida sobre la victimización. Conclusiones: los bajos niveles de aceptación de sí mismo y de la vida podrían ser un factor de riesgo de victimización; mientras que un alto desarrollo de competencias personales sería un factor de protección ante la victimización y la agresión en el cortejo adolescente. El PDV-Q posee óptimas propiedades psicométricas y es adecuado para medir la violencia psicológica en parejas de adolescentes colombianos.

Introduction: Studies on resilience and psychological violence in adolescent couples in Colombia are scarce, since violence in adult couples has been explored more frequently; in addition, the availability of optimal instruments for measuring psychological violence in adolescent courtship is limited. Objectives: Analyze the influence of resilience on psychological violence in adolescent couples; for this, the Psychological Violence Questionnaire in Partners (PVD-Q) was initially validated. Method: The study is explanatory-predictive and instrumental. The incidental sample consisted of 700 Colombian adolescents, aged 15 to 20 years (M = 18.40; SD = 1.56; 29.3 % men). Reliability, content and construct validity were recognized with factor analysis; Subsequently, structural equation models (SEM) were analyzed. Results: Adequate evidence of validity and optimal reliability values of the PVD-Q were recognized. The SEM model suggests inverse influences of personal competence on the role of aggression and victimization; as well as a direct influence of the acceptance of oneself and life on victimization. Conclusions: Low levels of acceptance of oneself and of life could be a risk factor for victimization; while a high development of personal skills would be a protective factor against victimization and aggression in adolescent courtship. The PVD-Q has optimal psychometric properties and is suitable for measuring psychological violence in couples of Colombian adolescents.

Who's driving? The default mode network in healthy elderly individuals at risk of cognitive decline.

Introduction: Age is the main risk factor for the development of neurocognitive disorders, with Alzheimer's disease being the most common. Its physiopathological features may develop decades before the onset of clinical symptoms. Quantitative electroencephalography (qEEG) is a promising and cost-effective tool for the prediction of cognitive decline in healthy older individuals that exhibit an excess of theta activity. The aim of the present study was to evaluate the feasibility of brain connectivity variable resolution electromagnetic tomography (BC-VARETA), a novel source localization algorithm, as a potential tool to assess brain connectivity with 19-channel recordings, which are common in clinical practice. Methods: We explored differences in terms of functional connectivity among the nodes of the default mode network between two groups of healthy older participants, one of which exhibited an EEG marker of risk for cognitive decline. Results: The risk group exhibited increased levels of delta, theta, and beta functional connectivity among nodes of the default mode network, as well as reversed directionality patterns of connectivity among nodes in every frequency band when compared to the control group. Discussion: We propose that an ongoing pathological process may be underway in healthy elderly individuals with excess theta activity in their EEGs, which is further evidenced by changes in their connectivity patterns. BC-VARETA implemented on 19-channels EEG recordings appears to be a promising tool to detect dysfunctions at the connectivity level in clinical settings.

Air Bubbles as an Admixture for Printable Concrete: A Review of the Rheological Effect of Entrained Air.

This article presents a review of the current solutions for the rheological challenge of three-dimensional concrete printing (3DCP), providing a rheological definition for printability, and an overview of the current techniques for obtaining a printable concrete, placing special emphasis on understanding structural build-up and the current mixture proportions and admixtures used to improve it. A promising alternative for improving structural build-up is the use of entrained air (EA), as bubbles, whose effects are reviewed in generic yield stress fluids and then specifically in concrete. After revision of micromechanical models and experimental trials from literature on yield stress fluid bubble suspensions and concrete, EA appears to be ideal for 3DCP when generated by anionic surfactants, as it increases static yield stress and decreases plastic viscosity. Cationic surfactants, however, maintain or slightly decrease static yield stress. It is proposed that the lubricating or stiffening property of the bubbles determines their ability to deform under the shear stress generated by the surrounding fluid. The ability to deform depends on the surfactant used to entrain the bubbles and the mixture design of the concrete. Further experimental research must be carried out for the advantages of EA to be fully realized.

Progress Toward Long-Term Care Protection in Latin America: A National Long-Term Care System in Costa Rica.

The aging of the world's population is a reality. People are living longer, not just in high-income countries, but it remains unclear whether their extra years will be lived in better health. In fact, an increasing number of older adults will probably require help to perform activities of daily living. Within the framework of its Global Strategy and Action Plan on Ageing and Health, the World Health Organization has called on all countries to create suitable and equitable long-term care systems that meet the needs of older people. The challenge is particularly acute in Latin America. The region is aging faster than other areas in the world, and its less-prepared social protection systems suffer from limited economic resources. Costa Rica is one the first middle-income countries to create a national long-term care system. This article describes the main characteristics of this system and discusses it from an international perspective. The results show that it has been designed to prioritize severity of dependency and cost containment, and to reinforce the formalization of care. The outcome of its implementation will affect the decisions of neighboring countries and those with similar economic conditions concerning the development of their own long-term care systems.

Is It Possible to Measure the Role of the Bystander and the Victim of Bullying in Children? Construct Validity of Two Brief Pictorial Scales With IRT and CFA Models.

The study's objective was to develop and validate the psychometric properties of two brief pictorial scales to evaluate the roles of bystanders and victims of bullying. A sample of 910 students was considered (49.6%, boys; 50.4%, girls) between the ages of 7 and 13 (M = 10, SD = 1.4). Both instruments present nine pictorial items representing two dimensions: physical bullying (items 1 to 4) and psychological bullying (items 5 to 9). An additional measure of anxiety was used to assess convergent validity. The Confirmatory Factorial Analysis shows that the two-dimensional oblique model, physical bullying and psychological bullying, presents a better fit to the bystander scale data (RMSEA = .040; CFI = .984; SRMR = .033) and in the victim scale (RMSEA = .051; CFI = .978; SRMR = .040) in comparison to other competitor models. From the perspective of the Item Response Theory (IRT), it was found that the items adequately discriminate the levels of the latent variable; therefore, items 1 (physical bullying) and 7 (psychological bullying) are the most accurate on the bystander scale, and items 3 (physical bullying) and 7 (psychological bullying), on the victim scale. It was also found that the degree of difficulty on both scales is lower for the psychological bullying dimension than for the physical bullying dimension. Both instruments demonstrated good psychometric properties; therefore, they can detect school bullying in classrooms.

O desafio de envelhecer na América Latina: cuidados prolongados na Costa Rica / The challenge of ageing in Latin America: long-term care in Costa Rica

Resumo Embora políticas públicas de cuidados prolongados estejam começando a ser implementadas na América Latina, poucos estudos analisam a situação dos países que compõem a região. Este estudo tem por objetivo examinar programas públicos de cuidados prolongados na Costa Rica e estimar a demanda do país por cuidados formais. Os dados foram obtidos por meio de revisão das Contas Nacionais de Saúde, cinco entrevistas com representantes de instituições governamentais, revisão da literatura científica e relatórios oficiais, e análise dos dados extraídos de uma pesquisa nacional de cuidados. Os resultados indicam a existência de programas fragmentados e focados no enfrentamento à pobreza que não foram projetados para atender às necessidades de cuidados prolongados. Estima-se que, atualmente, 13,4% dos idosos da região necessitam de ajuda na execução de atividades básicas da vida diária, e que o trabalho informal de cuidados é intensivo, oferecido principalmente por um membro da família, e não remunerado.

Abstract Latin America is beginning to implement long-term care public policies. But only a few studies look at the situation of the countries in the region. This study aims to examine long-term care public programs in Costa Rica and to estimate the country's demand for formal care. For this purpose, we have revised its National Health Accounts, conducted five interviews with representatives of governmental institutions, reviewed the scientific literature and official reports, and analyzed the data drawn from a national care survey. The results show the existence of fragmented, poverty-focused programs that were not designed for long-term care needs. The estimated percentage of older adults in the region that currently require help to perform activities of daily living is 13.4%. The informal care work is intensive, mostly provided by a family member, and unpaid.

Psychometric Properties of the SOC-13 Scale in Colombian Adults.

The aim of this study was to determine the psychometric properties of the Spanish version of the SOC-13 in Colombian adults. The SOC-13 questionnaire was administered to 489 individuals aged ≥18 years who were in lockdown from March to July 2020 in Nariño County, Colombia. Psychometric properties of the scale were examined using a cross-validation method via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Additionally, configural and metric invariance were tested. To determine the internal consistency of the questionnaire, McDonald's omega (ω), Cronbach's alpha (α), and composite reliability (CR) coefficients were estimated. The EFA determined that a three-factor structure best fit the data (comprehensibility, manageability, and meaningfulness) and CFA confirmed this three-factor model structure showing a good fit (χ2S-B = 188.530, χ2S-B/(62) = 3.615, p = 0.001; NNFI = 0.959; CFI = 0.968; RMSEA = 0.052 (90% CI [0.041-0.063]) and SRMR = 0.052).The invariance analysis indicated the same underlying theoretical structure between genders. Additionally, (ω), (α), and (CR) coefficients confirmed a high internal consistency of the instrument. The SOC-13 scale, reflecting comprehensibility, manageability, and meaningfulness, is a reliable and valid tool for assessing the sense of coherence in Colombian populations.

Propiedades psicométricas de la aversion to risk taking scale en una muestra de motociclistas colombianos / Psychometric Properties of the Aversion to Risk-Taking Scale in a Sample of Colombian Motorcyclists

Resumen Cada año cientos de motociclistas mueren en accidentes de tránsito. Una de las causas es la baja percepción del riesgo al conducir, que influye en la aparición de comportamientos riesgosos. El objetivo de este estudio fue adaptar y validar la escala Aversion to Risk Taking Scale (ARTS) en una muestra de motociclistas colombianos, para evaluar el riesgo percibido frente a distintos comportamientos considerados peligrosos en la vía. Participaron 436 motociclistas del Departamento de Nariño (Colombia), con edades entre 18 y 71 años (M= 28.27; DT= 8.68). Se actualizó la escala con dos nuevos ítems (consumo de sustancias psicoactivas y uso del casco); se realizó un ajuste lingüístico, se valoró la consistencia interna, las evidencias de validez de contenido, validez de constructo (análisis factorial exploratorio y confirmatorio) y validez comparada con la Escala de autoeficacia para la conducción. La ARTS presentó óptimas propiedades psicométricas para una estructura unifactorial. Se reconocen óptimos valores de consistencia interna (α= 0.94; ɷ= 0.95). Se evidenció una correlación inversa con la Escala de Autoeficacia para la Conducción, corroborando el constructo. Los resultados sugieren que la ARTS, adaptada y actualizada para Colombia, es una con calidad psicométrica probada; por tanto, es válida y confiable para evaluar la percepción del riesgo en motociclistas colombianos.

Abstract Every year hundreds of motorcyclists die in traffic accidents. One of the causes is the low perception of risk when driving, which influences the appearance of risky behaviors. The objective of this study was to adapt and validate the Aversion to Risk-Taking Scale (ARTS) in a sample of Colombian motorcyclists, to evaluate the perceived risk of different behaviors considered dangerous on the road. A total of 436 motorcyclists from Nariño (Colombia), aged between 18 and 71 years (M = 28.27; SD = 8.68), participated. The scale was updated with two new items (consumption of psychoactive substances and helmet use). A linguistic adjustment was performed; internal consistency and evidence of content validity, construct validity (exploratory and confirmatory factor analysis), and validity compared with the Driving Self‑Efficacy Scale were assessed. The ARTS presented optimal psychometric properties for a unifactorial structure. Optimal internal consistency values are recognized (α = 0.94; ɷ = 0.95). An inverse correlation with the Driving Self-Efficacy Scale was evidenced, corroborating the construct. The results suggest that the ARTS, adapted and updated for Colombia, is a scale with proven psychometric quality; therefore, it is valid and reliable to assess risk perception in Colombian motorcyclists.

[Long-term care in Costa Rica: Lessons for Latin America based on international evidenceCuidados de longa duração na Costa Rica: aprendizados para a América Latina partindo de evidências internacionais]. / Cuidados de larga duración en Costa Rica: enseñanzas para América Latina desde la evidencia internacional.

The growing prevalence of functional dependency as a result of accelerated aging and epidemiological transformation has created a pressing need to implement new systems to address the problem of long-term care (LTC) in the Region of the Americas. In March 2021, Costa Rica became the only middle-income country in the Region that has taken steps to introduce a national LTC system. The present article compares the design of this new LTC system with existing systems in Australia, Denmark, Japan, Spain, the United States of America, and Uruguay, and identifies useful lessons for the development of LTC systems in other countries of the Region. Four aspects are analyzed: the legal framework, access and coverage, types of services, and costs and financing. A search of the scientific literature and national and international reports was conducted between 1 January 2000 and 1 April 2021. The results showed that the incipient Costa Rican model follows the main trends that are seen internationally. It is progressively universal, prioritizes home care, incorporates technology tools, creates parameters for measuring the quality of services, provides monetary transfers for family members who serve as caregivers, includes respite services, and offers training for caregivers. At the same time, however, the international evidence shows that models with poor levels of funding have low coverage and offer little diversity in terms of the services provided. Insufficient funding, absence of new economic resources, and weak legal foundations are jeopardizing the expansion, development, and sustainability of the new model in the Americas.

A crescente prevalência de dependência funcional derivada do envelhecimento acelerado e da transformação epidemiológica torna inevitável a implementação de novos sistemas de cuidados de longa duração (CLD) na Região das Américas. Em março de 2021, a Costa Rica se transformou no único país de renda média na Região que iniciou a aplicação de um sistema nacional desse tipo. Neste artigo, compara-se o desenho do novo sistema de cuidados de longa duração da Costa Rica com os sistemas da Austrália, Dinamarca, Espanha, Estados Unidos da América, Japão e Uruguai, e se identificam aprendizados úteis para o desenvolvimento de outros sistemas de CLD na Região. São analisados quatro aspectos: o marco legal, o acesso e a cobertura, os tipos de serviço, os custos e o financiamento. Para isso, foi realizada uma revisão da bibliografia científica e de relatórios nacionais e internacionais entre 1º de janeiro de 2000 e 1º de abril de 2021. O modelo inicial segue as principais tendências da experiência internacional. É progressivamente universal, prioriza a atenção domiciliar, inclui ferramentas tecnológicas, cria parâmetros de qualidade para os serviços, incorpora transferências monetárias para familiares que atuam como cuidadores, inicia serviços de cuidados intermitentes e desenvolve formação para cuidadores. No entanto, a evidência internacional mostra que os modelos com menor financiamento têm baixa cobertura e pouca diversidade de serviços. A escassa generosidade fiscal, a ausência de novas fontes de recursos econômicos e a vulnerabilidade jurídica colocam em risco a ampliação, o desenvolvimento e a sustentabilidade do novo modelo nas Américas.