Theranostic applications of multifunctional carbon nanomaterials.

Nanobiotechnology is one of the leading research areas in biomedical science, developing rapidly worldwide. Among various types of nanoparticles, carbon nanomaterials (CNMs) have attracted a great deal of attention from the scientific community, especially with respect to their prospective application in the field of disease diagnosis and therapy. The unique features of these nanomaterials, including favorable size, high surface area, and electrical, structural, optical, and chemical properties, have provided an excellent opportunity for their utilization in theranostic systems. Carbon nanotubes, carbon quantum dots, graphene, and fullerene are the most employed CNMs in biomedical fields. They have been considered safe and efficient for non-invasive diagnostic techniques such as fluorescence imaging, magnetic resonance imaging, and biosensors. Various functionalized CNMs exhibit a great capacity to improve cell targeting of anti-cancer drugs. Due to their thermal properties, they have been extensively used in cancer photothermal and photodynamic therapy assisted by laser irradiation and CNMs. CNMs also can cross the blood-brain barrier and have the potential to treat various brain disorders, for instance, neurodegenerative diseases, by removing amyloid fibrils. This review has summarized and emphasized on biomedical application of CNMs and their recent advances in diagnosis and therapy.

1α,25-(OH)2 vitamin D3 prevents insulin resistance and regulates coordinated exocytosis and insulin secretion.

Vitamin D3 is associated with improvements in insulin resistance and glycemia. In this study, we investigated the short-term effect of 1α,25(OH)2 Vitamin D3 (1,25-D3) and cholecalciferol (vitamin D3) on the glycemia and insulin sensitivity of control and dexamethasone-induced insulin-resistance rats. 45Ca2+ influx responses to 1,25-D3 and its role in insulin secretion were investigated in isolated pancreatic islets from control rats. In vivo, 5 d treatment with 1,25-D3 (i.p.) prevented insulin resistance in dexamethasone-treated rats. Treatment with 1,25-D3 improved the activities of hepatic enzymes, serum lipids and calcium concentrations in insulin-resistant rats. 25-D3 (o.g.) does not affect insulin resistance. In pancreatic islets, 1,25-D3 increased insulin secretion and stimulated rapid response 45Ca2+ influx. The stimulatory effect of 1,25-D3 on 45Ca2+ influx was decreased by diazoxide, apamine, thapsigargin, dantrolene, 2-APB, nifedipine, TEA, PKA, PKC, and cytoskeleton inhibitor, while it was increased by glibenclamide and N-ethylmaleimide. The stimulatory effect of 1,25-D3 on 45Ca2+ influx involves the activation of L-type VDCC, K+-ATP, K+-Ca2+, and Kv channels, which augment cytosolic calcium. These ionic changes mobilize calcium from stores and downstream activation of PKC, PKA tethering vesicle traffic and fusion at the plasma membrane for insulin secretion. This is the first study highlighting the unprecedented role of 1,25-D3 (short-term effect) in the regulation of glucose homeostasis and on prevention of insulin resistance. Furthermore, this study shows the intracellular ß-cell signal transduction of 1,25-D3 through the modulation of pivotal ionic channels and proteins exhibiting a coordinated exocytosis of vesicles for insulin secretion.

Methodological proposal for the identification of tourist routes in a particular region through clustering techniques.

The tourism sector has an essential role in the sustainable development of a country. Therefore, in this research we propose a methodology to identify tourist routes that integrate the most important Points Of Interest in a region taking up as criteria profile characteristics in common between the sites evaluated using clustering techniques. To attain this goal, firstly, a literature review focused on compiled information used for location selection and evaluation in attraction potential sites. Then, clustering techniques are applied to identify similarities between sites, and finally, a layout of tourist routes is presented. We applied this methodology using data from a Region in Colombia. As a result, eight factors are proposed: Natural, Cultural, Tourist Plant, Infrastructure, Superstructure, Accessibility, Human and Tourist Capital and Security. From the second phase, three tourist groups were identified with three tourism factors for each of them; and then, two examples of tourist routes are proposed.

HLA-B Allele, Genotype, and Haplotype Frequencies in a Group of Healthy Individuals in Colombia.

BACKGROUND: The sequencing of alleles of the HLA-B, a human leukocyte antigen (HLA) class I gene, was established as the most polymorphic of chromosome 6 and of the entire human genome. In this locus, the HLA-B*27 allele is highly polymorphic and has clinical relevance. Literature about the subtypes and singular frequency of these alleles in Colombia's healthy population is scarce. OBJECTIVE: The aim of this study was to establish the HLA-B allele, genotype, and haplotype frequencies in a healthy Colombian population and analyze their association with the sex and geographical distribution of the individuals studied. METHODS: This is a nonexperimental and descriptive study. The data from whole-blood samples whose HLA genes were genotyped by protocol with the Luminex 100/200 xMAP technology were evaluated. HLA-B*27 positivity was confirmed by the new-generation sequencing technology. The associations between the HLA-B alleles and demographic variables were evaluated by χ2 and Fisher exact tests. RESULTS: Twenty-seven HLA-B genotypes were identified in 255 individuals, with the highest frequencies for HLA-B*35 (44.7%), B*40 (19.6%), and B*44 (16.8%). Additionally, 89 HLA-B alleles were found; the most common were HLA-B*35:01 (6.7%) and B*40:02 (6.5%). Nine individuals tested positive for the HLA-B*27 allele with genotype and allele frequencies of 3.5% and 1.8%, respectively; the HLA-B*27:05:02 subtype predominated. CONCLUSIONS: Here, we report the most common HLA-B allele, genotype, and haplotype frequencies in a healthy Colombian population group and analyzed their association with the sex and geographical distribution of the individuals studied. Results for the HLA-B*27 allele confirm racial mixing in Colombia with a high degree of Caucasian influence, as well as the repopulation of Colombia's central region, attributed to the migration phenomena. Results agree with data published in Colombia that was obtained from cord blood samples.

Análisis del perfil de ácidos grasos y propiedades fisicoquímicas del aceite de palma de mil pesos (Oenocarpus Bataua) / Analysis of the Fatty Acid Profile and Physicochemical Properties of Oil from the Thousand Peso Palm (Oenocarpus Bataua)

Resumen Antecedentes: la palma de mil pesos (Oenocarpus bataua) es una especie promisoria, tanto por sus frutos ricos en aceite de excelente condición como por su especial adaptación a suelos pobres. Objetivo: analizar el perfil de ácidos grasos y propiedades fisicoquímicas del aceite de palma de mil pesos. Materiales y métodos: se analizaron las propiedades fisicoquímicas, el porcentaje de saturación con técnicas del AOAC y el perfil de ácidos grasos mediante cromatografía líquida de gases con detector de ionización de llama (CG-FID). Resultados: el aceite analizado tiene un perfil de ácidos grasos parecido al del aceite de oliva, con la siguiente distribución porcentual de ácidos grasos: palmítico (11,9±1,1), oleico (76,1±1), linoleico (3±0,4), α-linolénico (1,9±0,3), con predominio de grasas monoinsaturadas (77,0±1,0 %), moderado aporte de saturadas (18,1±1,2 %) y bajo de poliinsaturadas (4,9±0,6 %), esto último sería la única limitante para utilizarlo como única fuente de grasa para la preparación de alimentos, por lo demás cumple con la norma colombiana para el aceite de palma alto oleico en cuanto al perfil de ácidos grasos y sus características físicoquímicas. Conclusiones: el aceite estudiado es potencialmente comercializable para el consumo humano y tiene beneficios para la salud cardiovascular de los consumidores.

Abstract Background: The thousand peso palm tree (Oenocarpus bataua) is a promising species, both for its oil-rich fruits of excellent properties and for its unique adaptation to poor soils. Objective: Analyze the fatty acid profile and physicochemical properties of oil from the thousand peso palm tree. Materials and Methods: The physicochemical properties and the percentage of saturation ere found using AOAC techniques, and the fatty acid profile was analyzed by liquid gas chromatography with flame ionization detector (GC-FID). Results: The oil analyzed had a fatty acid profile similar to olive oil, with the following percentage distribution of fatty acids: palmitic (11.9±1.1), oleic (76.1±1), linoleic (3±0.4), α-linolenic (1.9±0.3), with a predominance of monounsaturated fats (77.0±1.0%), moderate contribution of saturated (18.1±1.2%) and low polyunsaturated (4.9±0.6%). Only the polyunsaturated profile would constitute a limitation for use as a sole source of fat for food preparation, otherwise thousand peso palm oil complies with the Colombian standard for high oleic palm oil in terms of the fatty acid profile and its physicochemical characteristics. Conclusions: The oil studied is potentially marketable for human consumption and has cardiovascular health benefits for consumers.

Association of ERAP2 polymorphisms in Colombian HLA-B27+ or HLA-B15+ patients with SpA and its relationship with clinical presentation: axial or peripheral predominance.

OBJECTIVE: To determine the association between endoplasmic reticulum aminopeptidase (ERAP)1 and ERAP2 single-nucleotide polymorphisms (SNPs) and human leukocyte antigens (HLA)-B27+ or HLA-B15+ patients with spondyloarthritis (SpA). METHODS: 104 patients with SpA according to Assessment of Spondyloarthritis International Society criteria were included in the study. HLA typing was performed by PCR. The polymorphisms were determined by real-time PCR on genomic DNA using customised probes for SNPs rs27044, rs17482078, rs10050860 and rs30187 in ERAP1, and rs2910686, rs2248374 and rs2549782 in ERAP2. RESULTS: 70 of the104 patients with SpA were HLA-B27+ and 34 were HLA-B15+. The distribution of ERAP1 and ERAP2 SNPs between the HLA-B15+ and HLA-B27+ patients with SpA did not reveal differences. Likewise, no differences in the frequencies of ERAP1 SNP haplotypes and alleles HLA-B15 or HLA-B27 were found. Interestingly, however, the frequencies of three particular haplotypes formed by ERAP2 SNPs rs2549782/rs2248374/rs2910686 varied between HLA-B15+ and HLA-B27+ patients: the ERAP2 SNPs haplotype TGT was more common in HLA-B15+ patients with SpA (OR 2.943, 95% CI 1.264 to 6.585; P=0.009), whereas the ERAP2 SNP haplotypes TGC and CAT were more associated with HLA-B27+ patients with SpA: (OR 4.483, 95% CI 1.524 to 13.187; p=0.003) and (OR 9.014, 95% CI 1.181 to 68.807; p=0.009), respectively. CONCLUSION: An association was found between HLA-B15+ patients with SpA and haplotype TGT of ERAP2 SNPs. On the other hand, HLA-B27+ patients with SpA were associated with ERAP2 haplotypes TGC and CAT. These associations could be related to the clinical presentation of the disease, specifically with a peripheral or axial predominance, respectively.

IL-26 mediated human cell activation and antimicrobial activity against Borrelia burgdorferi.

Lyme disease is an inflammatory disease caused by infection with Borrelia burgdorferi (Bb). Inflammatory sequelae of Bb infection appear to be refractory to antibiotics. An antimicrobial peptide with the ability to bind the DNA in the tissue could serve as a viable option of treatment for chronic complications of Lyme borreliosis. DNA of Bb can remain in tissues causing a prolonged inflammatory response that lead to chronic joint pain. Here we examined the effect of IL-26, a newly reported antimicrobial protein, against Bb DNA. An antimicrobial effect of IL-26 on the spirochete was observed. In human macrophages, IL-26 treated cells showed an increase in IRF activation upon Bb stimulation. Moreover, IL-26 treated macrophages showed an increased in phagocytic activity compared to untreated cells. Although no Bb DNA degradation was observed using a TUNEL assay run in an agarose gel, a Comet assay on whole bacteria showed cellular and Bb DNA degradation by IL-26. Our results showed that IL-26 (monomer and dimer) has not only the potential to control Bb growth in vitro, but it also enhances the anti-borrelial response of human macrophages. Further research aiming to characterize the role of IL-26 in controlling other aspects of the inflammatory response that could provide insight of its potential therapeutic applications are needed.

Gustos, consumo y acceso a los alimentos: opinión de escolares de Santander, Colombia / Tastes, consumption and access to food: opinion of schoolchildren in Santander, Colombia

FUNDAMENTOS: Las investigaciones sobre los hábitos, prácticas o conductas alimentarias en la infancia centran su atención en cuidadores o familiares. El objetivo fue describir el hábito alimentario en términos de gustos, consumo y acceso desde la opinión de la población infantil (4 a 12 años) de instituciones educativas públicas en 22 municipios del departamento de Santander, Colombia. MÉTODOS: Estudio de corte transversal, muestreo bietápico, se calculó un tamaño de muestra de 1.507 escolares. Se construyó un instrumento que evaluó 3 características de los hábitos alimentarios (gustos, consumo y acceso). RESULTADOS: Participaron 1.615 escolares; el promedio de edad fue 10 DE1,95 años, 50% eran hombres, el 66% residía en zona urbana. El reporte de gusto por alimentos como el pollo fue de 95%, arroz y gelatina 97%, manzana 97%, tomate 87%. La mayoría de alimentos se consumen 1 vez al día, más del 90% reportó la familia como fuente de acceso a los alimentos. CONCLUSIONES: Desde la opinión de escolares, las carnes, los cereales, las raíces, los tubérculos y los plátanos, son los alimentos preferidos; las verduras son menos apreciados. La mayoría de alimentos se consumen 1 vez al día y el hogar es el principal proveedo

BACKGROUND: Research on childhood habits, practices or eating behaviors focuses on caregivers or family members. The objective wasto describe the alimentary habit in terms of tastes, consumption and access from the opinion of the child population (4 to 12 years) of public educational institutions in 22 municipalities of the Department of Santander, Colombia. METHODS: Cross-sectional study, two-stage sampling, a sample size of 1,507 schoolchildren was calculated. It was built an instrument that evaluated 3 characteristics of eating habits (tastes, consumption and access). RESULTS: 1.615 school children participated; the mean age was 10 SD 1,95 years, 50% were men, 66% lived in urban areas. The taste report for foods such as chicken was 95%, rice and gelatin 97%, apple 97%, tomato 87%. Most foods are consumed 1 time a day, more than 90% reported family as a source of access to food. CONCLUSIONS: From the opinion of schoolchildren, meat, cereals, roots, tubers and bananas are the preferred foods; vegetables are the least appreciated. Most foods are consumed 1 time a day and the family is the main provider

Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014-2015.

In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.

Motivaciones que inciden en la participación de docentes en procesos de educación para la sexualidad / Motivations affecting the participation of teachers in sex education processes

Resumen Objetivos: Determinar las características de la motivación y comprender los significados que tiene, para los colectivos docentes, participar en procesos formativos en educación para la sexualidad. Metodología: Método mixto: etapa cuantitativa fundamentada en la teoría de Deci y Ryan, evaluó motivación interna, externa y desmotivación, utilizando el modelo de Rasch; etapa cualitativa con enfoque fenomenológico y aplicación de entrevistas semiestructuradas. Resultados: Participaron 104 docentes de siete instituciones educativas del municipio de Socorro - Santander. El análisis sobre ítems y docentes, según modelo Rasch, para los tres tipos de motivación, tuvo buenos resultados que permitieron identificar las características relacionadas, así como determinar que la motivación interna fue la que llevó a la mayoría de docentes a participar en el proceso formativo de educación para la sexualidad. Esto fue corroborado por las entrevistas, evidenciando que el colectivo docente interpretó dicho proceso como una oportunidad para mejorar su práctica docente y aumentar sus conocimientos en el tema. Conclusiones: La ubicación del 66% de docentes en lo alto de la escala de motivación interna permitió identificar la fuerza motivacional para asistir al proceso formativo. Atender a intereses y necesidades, así como reforzar la autonomía y la autodeterminación en grupos docentes que requieren capacitación en educación para la sexualidad, es una buena forma de lograr participación y compromiso estable y duradero como formadores en el área. De acuerdo con la búsqueda bibliográfica realizada, este estudio sobre la motivación y los procesos de capacitación docente en educación para la sexualidad es pionero.

Abstract Objectives: To determine the characteristics of motivation and to understand the significance for teachers, related to participation in sex education training processes. Methodology: Mixed method: quantitative phase based on the theory of Deci and Ryan, internal and external motivation, and demotivation were assessed using the Rasch model; qualitative stage, with a phenomenological approach, included the application of a semi-structured interview. Results: 104 teachers from seven educational institutions in Socorro-Santander participated in the study. Analysis of items and teachers, according to the Rasch model for the three types of motivation, had good results that allowed us to identify the related characteristics and to determine that internal motivation led, on the majority of teachers, to participate in the formative process of sex education. This was corroborated by the interviews, where teachers interpreted the process as an opportunity to improve their teaching practice and increase their knowledge on the subject. Conclusions: The allocation of 66% of teachers at the top of the internal motivation scale allowed us to identify the motivational force to attend the formative process. To respond to interests and needs, as well as to reinforce autonomy and self-determination in educational groups that require training in sex education, is a good way to achieve stable and lasting participation and commitment as trainers in the area. Based on our bibliographic search, this study on motivation and the processes of teacher training in sex education is a pioneer.

The potent insulin secretagogue effect of betulinic acid is mediated by potassium and chloride channels.

Betulinic acid (BA) has been described as an insulin secretagogue which may explain its potent antihyperglycemic effect; however, the exact role of BA as an insulinogenic agent is not clear. The aim of this study was to investigate the mechanism of BA on calcium influx and static insulin secretion in pancreatic islets isolated from euglycemic rats. We found that BA triggers calcium influx by a mechanism dependent on ATP-dependent potassium channels and L-type voltage-dependent calcium channels. Additionally, the voltage-dependent and calcium-dependent chloride channels are also involved in the mechanism of BA, probably due to an indirect stimulation of calcium entry and increased intracellular calcium. Additionally, the downstream activation of PKC, which is necessary for the effect of BA on calcium influx, is involved in the full stimulatory response of the triterpene. BA stimulated the static secretion of insulin in pancreatic islets, indicating that the abrupt calcium influx may be a key step in its secretagogue effect. As such, BA stimulates insulin secretion through the activation of electrophysiological mechanisms, such as the closure of potassium channels and opening of calcium and chloride channels, inducing cellular depolarization associated with metabolic-biochemical effects, in turn activating PKC and ensuring the secretion of insulin.

The prohibitin protein complex promotes mitochondrial stabilization and cell survival in hematologic malignancies.

Prohibitins (PHB1 and PHB2) have been proposed to play important roles in cancer development and progression, however their oncogenic mechanism of action has not been fully elucidated. Previously, we showed that the PHB1 and PHB2 protein complex is required for mitochondrial homeostasis and survival of normal human lymphocytes. In this study, novel evidence is provided that indicates mitochondrial prohibitins are overexpressed in hematologic tumor cells and promote cell survival under conditions of oxidative stress. Immunofluorescent confocal microscopy revealed both proteins to be primarily confined to mitochondria in primary patient lymphoid and myeloid tumor cells and tumor cell lines, including Kit225 cells. Subsequently, siRNA-mediated knockdown of PHB1 and PHB2 in Kit225 cells significantly enhanced sensitivity to H2O2-induced cell death, suggesting a protective or anti-apoptotic function in hematologic malignancies. Indeed, PHB1 and PHB2 protein levels were significantly higher in tumor cells isolated from leukemia and lymphoma patients compared to PBMCs from healthy donors. These findings suggest that PHB1 and PHB2 are upregulated during tumorigenesis to maintain mitochondrial integrity and therefore may serve as novel biomarkers and molecular targets for therapeutic intervention in certain types of hematologic malignancies.

Effects of chronic iTBS-rTMS and enriched environment on visual cortex early critical period and visual pattern discrimination in dark-reared rats.

Early cortical critical period resembles a state of enhanced neuronal plasticity enabling the establishment of specific neuronal connections during first sensory experience. Visual performance with regard to pattern discrimination is impaired if the cortex is deprived from visual input during the critical period. We wondered how unspecific activation of the visual cortex before closure of the critical period using repetitive transcranial magnetic stimulation (rTMS) could affect the critical period and the visual performance of the experimental animals. Would it cause premature closure of the plastic state and thus worsen experience-dependent visual performance, or would it be able to preserve plasticity? Effects of intermittent theta-burst stimulation (iTBS) were compared with those of an enriched environment (EE) during dark-rearing (DR) from birth. Rats dark-reared in a standard cage showed poor improvement in a visual pattern discrimination task, while rats housed in EE or treated with iTBS showed a performance indistinguishable from rats reared in normal light/dark cycle. The behavioral effects were accompanied by correlated changes in the expression of brain-derived neurotrophic factor (BDNF) and atypical PKC (PKCζ/PKMζ), two factors controlling stabilization of synaptic potentiation. It appears that not only nonvisual sensory activity and exercise but also cortical activation induced by rTMS has the potential to alleviate the effects of DR on cortical development, most likely due to stimulation of BDNF synthesis and release. As we showed previously, iTBS reduced the expression of parvalbumin in inhibitory cortical interneurons, indicating that modulation of the activity of fast-spiking interneurons contributes to the observed effects of iTBS.

[Validating mid-upper arm circumference (MUAC) measurement for detecting acute malnutrition in 6-59 month-old children in emergency and disaster situations]. / Validez de la cinta braquial para detección de desnutrición aguda en niñas y niños entre 6 y 59 meses de edad en escenarios de emergencias y desastres.

OBJECTIVES: Validating the results of mid-upper arm circumference (MUAC) measurement in 6-59 month-old children when MUAC was measured by community agents in areas where an emergency had been declared. Evaluating the cut-offs used for identifying children suffering from acute malnutrition in Colombia today. METHODOLOGY: Previously trained community agents and a nutritionist carried out a cross-sectional study for evaluating MUAC agreement, reproducibility and sensitivity in detecting acute malnutrition. Three hundred and six children were assessed in three municipalities where an emergency had been declared in the Cordoba department of Colombia. RESULTS: A Bland and Altman plot gave high agreement regarding measurements taken by the community agents and the nutritionist, 94 % of the measurements coming within the agreement limits. The intra-class correlation coefficient gave 0.87 reproducibility; however, validating the criterion for calculating the area below the ROC curve, sensitivity and the impact of the children's age on MUAC measurements highlighted problems in using 11.5 centimeters as the cut-off. CONCLUSIONS: MUAC measurement was reliable, had good reproducibility and led to rapid diagnosis of nourishment status in 6-59 month-old children living in areas where an emergency had been declared. Validating the criterion, sensitivity, the impact of the children's age on MUAC measurement results and improved nourishment status concerning children aged less than 5 years old in Colombia highlighted the need for changing the current cut-off and using 14 centimeters instead.

Validez de la cinta braquial para detección de desnutrición aguda en niñas y niños entre 6 y 59 meses de edad en escenarios de emergencias y desastres / Validating mid-upper arm circumference (MUAC) measurement for detecting acute malnutrition in 6-59 month-old children in emergency and disaster situations

Objetivos Establecer la validez de resultados en medición del contorno medio del brazo CMB de menores de 6 a 59 meses utilizando la cinta braquial por agentes comunitarios en situaciones de emergencia y evaluar puntos de corte utilizados para identificar desnutrición aguda en el contexto colombiano actual. Metodología Se realizó estudio trasversal para evaluar concordancia, reproducibilidad y sensibilidad en la detección de desnutrición aguda mediante uso de cinta braquial por agente comunitario capacitado y profesional en nutrición. Se valoraron 306 menores en tres municipios en emergencia del departamento de Córdoba, Colombia. Resultados La concordancia en las mediciones por agente comunitario y profesional según Bland y Altman, fue alta con el 94 % de las medidas dentro de límites de acuerdo; la reproducibilidad de resultados utilizando el coeficiente de correlación intraclase, fue de 0.87. Por su parte, la validez de criterio calculando el área bajo la curva de ROC, la sensibilidad y la influencia de la edad de los menores en resultados de la medida del CMB, mostraron problemas en el uso de 11.5 cms como punto de corte. Conclusiones La cinta braquial, utilizada por agentes comunitarios capacitados, es fiable, tiene muy buena reproducibilidad y permite el diagnóstico rápido del estado nutricional de menores entre 6 y 59 meses en situación de emergencia. La validez de criterio, sensibilidad, influencia de la edad de los menores en resultados de la medición del CMB y mejora en la situación nutricional en Colombia, mostraron la necesidad de cambiar el punto de corte a 14 centímetros.

Objectives Validating the results of mid-upper arm circumference (MUAC) measurement in 6-59 month-old children when MUAC was measured by community agents in areas where an emergency had been declared. Evaluating the cut-offs used for identifying children suffering from acute malnutrition in Colombia today. Methodology Previously trained community agents and a nutritionist carried out a cross-sectional study for evaluating MUAC agreement, reproducibility and sensitivity in detecting acute malnutrition. Three hundred and six children were assessed in three municipalities where an emergency had been declared in the Cordoba department of Colombia. Results A Bland and Altman plot gave high agreement regarding measurements taken by the community agents and the nutritionist, 94 % of the measurements coming within the agreement limits. The intra-class correlation coefficient gave 0.87 reproducibility; however, validating the criterion for calculating the area below the ROC curve, sensitivity and the impact of the children's age on MUAC measurements highlighted problems in using 11.5 centimeters as the cut-off. Conclusions MUAC measurement was reliable, had good reproducibility and led to rapid diagnosis of nourishment status in 6-59 month-old children living in areas where an emergency had been declared. Validating the criterion, sensitivity, the impact of the children's age on MUAC measurement results and improved nourishment status concerning children aged less than 5 years old in Colombia highlighted the need for changing the current cut-off and using 14 centimeters instead.

Programas de educación sexual y reproductiva: significados asignados por jóvenes de cuatro municipios de Santander, Colombia / Sexual and reproductive education programs: meanings assigned by young people from four municipal districts of Santander, Colombia / Programas de educação sexual e reproductiva: significados estabelecidos por jovens de quatro municipios de Santander, Colombia

Objetivo: Comprender los significados que las y los jóvenes asignan a su participación en tres programas de educación para la salud sexual y reproductiva en Bucaramanga, Floridablanca, Lebrija y Socorro, que permitan contribuir al mejoramiento de los programas educativos impartidos en estos grupos poblacionales. Metodología: Estudio cualitativo con enfoque descriptivo, realizado en Bucaramanga, Floridablanca, Lebrija y Socorro en el periodo de octubre de 2011 a abril de 2012. Se realizaron entrevistas semiestructuradas grupales e individuales a las y los jóvenes de los cuatro municipios que participaron en los programas, utilizándose el diseño metodológico de Taylor & Bogdan para el análisis de las entrevistas. Resultados: Las y los jóvenes participantes en los programas educativos identificaron la experiencia como positiva, que impactó en los diferentes escenarios de sus vidas, resaltando el fortalecimiento de sus habilidades de comunicación y los derechos sexuales como contenido temático de mayor recordación. Conclusiones: Las y los jóvenes construyeron significados de su participación en el programa tanto de manera individual como grupal en la interacción social, los cuales han influido en la vivencia de su sexualidad y en las prácticas en los diversos escenarios de sus vidas, en los roles como hijos, amigos, pareja, líderes y como parte de un grupo social

Objective: To understand the meanings youngsters give to their participation in three education programs for sexual and reproductive health in Bucaramanga, Floridablanca, Lebrija and Socorro, which contribute to the improvement of the educational programs offered to these population groups. Methodology: A qualitative descriptive approach, carried out in Bucaramanga, Floridablanca, Lebrija and Socorro in the period of October 2011 to April 2012. Semi-structured group and individual interviews were conducted with the youngsters of the four municipalities who participated in the program, using the Taylor & Bogdan’s methodological design for the analysis of the interviews. Results: Youngsters participating in the educational programs identified them as a positive experience that impacted different scenarios in their lives, highlighting the strengthening of communication skills and sexual rights as thematic content of greater remembrance. Conclusions: The youngsters constructed meanings from their participation in the program both individually and in groups through social interaction, which have influenced their sexuality experience and the practices at various stages of their lives, in their roles as children, as friends, as a couple, as leaders and as part of a social group

Objetivo: Compreender os significados que as e os jovens outorgam a sua participação em três programas de educação para a saúde sexual e reprodutiva em Bucaramanga, Floridablanca, Lebrija e Socorro, que permitam contribuir ao melhoramento dos programas educativos distribuídos nestes grupos povoações. Metodologia: Estudo qualitativo com enfoque descritivo, realizado em Bucaramanga, Floridablanca, Lebrija e Socorro no período de outubro de 2011 a abril de 2012. Realizaram se entrevistas semi - estruturadas grupais e individuais às e os jovens dos quatro municípios que participaram nos programas, utilizando se o desenho metodológico de Taylor & Bogdan para o analise das entrevistas. Resultados: As e os jovens participantes nos programas educativos identificaram a experiência como positiva, que nos impactou diferentes cenários de suas vidas, resaltando o fortalecimento de suas habilidades de comunicação e os direitos sexuais como conteúdo temático de maior recordação. Conclusões: As e jovens construíram significados de sua participação no programa tanto de maneira individual como grupal na interação social, os quais tem influído na vivencia de sua sexualidade e nas praticas-nos diversos cenários de suas vidas, nos roles como filhos, amigos, casal, lideres e como parte dum grupo social

Cambios persistentes en conocimientos, actitudes y prácticas sobre sexualidad en adolescentes y jóvenes escolarizados de cuatro municipios de Santander - Colombia / Persistent changes in knowledge, attitudes and practices related to sexuality in adolescents and young students from four municipalities in Santander - Colombia

Introducción: La educación para la sexualidad hace parte del compromiso de formación integral de las instituciones educativas en Colombia; por eso evaluar características de estos procesos educativos y buscar asociación con cambios en conocimientos, actitudes y prácticas en adolescentes y jóvenes, aporta información para reorientar y enriquecer estrategias y programas en este campo. Metodología: Estudio observacional de corte longitudinal analítico en adolescentes y jóvenes entre 12 y 19 años quienes recibieron un proceso de educación para la sexualidad y tres mediciones de conocimientos, actitudes y prácticas mediante encuesta, previo consentimiento informado. La última medición se hizo dos años después del proceso educativo inicial. En el análisis se buscó la asociación de variables mediante coeficiente de correlación de Spearman, la t de Student o chi cuadrado dependiendo del tipo y características de las variables. Resultados: Grupos de 244, 111 y 139 estudiantes participaron en las mediciones. En conocimientos se encontró diferencia significativa por sexo a favor de las mujeres y mejores conocimientos en el grupo que ha tenido relaciones sexuales, en tanto que las actitudes fueron mejores entre quienes no las han tenido; así mismo se encontró correlación entre actitudes y prácticas. Las técnicas didácticas con significancia estadística fueron el cine-foro para conocimientos y el taller para actitudes. Y como agente educativo solo mostró diferencia el personal de bienestar estudiantil para trabajar las actitudes. Conclusiones: Es necesario continuar desarrollando investigación sobre los procesos de educación para la sexualidad, pues la efectividad del trabajo educativo observado en la persistencia e integralidad de cambios en conocimientos, actitudes y prácticas aún deja muchos interrogantes. Salud UIS 2012; 44 (2):21-33.

Introduction: The education for sexuality is part of the commitment to integral formation made by educative institutions in Colombia; therefore, the evaluation of these features of the educative processes and the search of association with changes in knowledge, attitudes and practices among adolescents and youngsters provide information to guide and enrich strategies and programs in this field. Methodology: Observational and analytical longitudinal study among adolescents and youngsters with age between 12 and 19 years who received an educational process for sexuality and three measures tests of their knowledge, attitudes and practices were taken throughout a inquest, with a previous informed consent. The last measurement was done two years later from the initial educative process. In the analysis the association of variables was sought out using the Spearman correlation coefficient, the Student's T distribution or chi squared test depending on the type and characteristics of the variables. Results: groups of 244, 111 and 139 students participated in the measuring. In terms of their knowledge a significant difference was found between genders favoring women and the group who has had sexual intercourse; in contrast, the attitudes were best between those who have not had it. Likewise, it was found that there was a correlation between attitudes and practices. The didactic techniques with a statistical significance were the movie forum for knowledge and the workshop for attitudes. As educative agent the students welfare staff was the only that showed a difference when working with attitudes. Conclusions: Since the effectiveness of the educative training observed in the persistence and integrality of changes in knowledge, attitudes and practices still leaves many questions, it is necessary to continue the development of research about the processes of education for sexuality. Salud UIS 2012; 44 (2):21-33.

HIV care providers' implementation of routine alcohol reduction support for their patients.

Screening and brief intervention (SBI) for alcohol reduction is an important health promoting strategy for patients with HIV, and HIV care providers are optimally situated to support their patients' reduction efforts. We report results from analyses that use data collected from providers (n = 115) in 7 hospital-based HIV care centers in the New York City metropolitan area in 2007 concerning their routine use of 11 alcohol SBI components with their patients. Providers routinely implemented 5 or more of these alcohol SBI components if they (1) had a specific caseload (and were therefore responsible for a smaller number of patients), (2) had greater exposure to information about alcohol's effect on HIV, (3) had been in their present positions for at least 1 year, and (4) had greater self efficacy to support patients' alcohol reduction efforts. Findings suggest the importance of educating all HIV care providers about both the negative impact of excessive alcohol use on patients with HIV and the importance and value of alcohol SBIs. Findings also suggest the value of promoting increased self efficacy for at least some providers in implementing alcohol SBI components, especially through targeted alcohol SBI training.