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1.
Braz. j. biol ; 83: e250235, 2023. graf
Artículo en Inglés | MEDLINE, LILACS, VETINDEX | ID: biblio-1339353

RESUMEN

Abstract The Neotropical freshwater cladoceran Bergamina lineolata (Sars, 1901) was found in a small temporal pond in the Magdalena department. Hitherto, it has been reported in Brazil and El Salvador. It was originally described as Alonella lineolata by Sars, 1901 from Brazil and then placed to the genus Bergamina by Elmoor-Loureiro et al. (2013). This is the first record of this species in Colombia. B. lineolata can be identified by a unique combination of characters including: 1) a remarkably large and oblong postabdomen, with three denticles on distal corner; 2) basal spine of the claw very short, length less than the half claw diameter at base; 3) IDL with two setae shorter than ODL seta, armed with fine setules unilaterally in terminal half; 4) endite 1 of trunk limb I with a long smooth seta between endites 1 and 2.


Resumo O cladócero neotropical de água doce Bergamina lineolata (Sars, 1901) foi encontrado em uma pequena lagoa temporária no departamento de Magdalena, na Colômbia. Até o momento, havia sido relatado no Brasil e em El Salvador. Foi originalmente descrito como Alonella lineolata por Sars, 1901 no Brasil, e, em seguida, colocado no gênero Bergamina por Elmoor-Loureiro et al. (2013). Esse é o primeiro registro dessa espécie na Colômbia. B. lineolata pode ser identificada por uma combinação única de caracteres, incluindo: 1) um pós-abdômen notavelmente grande e oblongo, com três dentículos no ângulo distal; 2) espinho basal da garra muito curto, comprimento menor que o diâmetro da metade da garra na base; 3) IDL com duas cerdas mais curtas que cerdas ODL, armadas com sétulas finas unilateralmente na metade terminal; e 4) endito 1 do toracópodo I com uma longa cerda lisa entre os enditos 1 e 2.


Asunto(s)
Animales , Cladóceros , Brasil , Colombia , Tamaño Corporal , Distribución Animal
2.
BMC Womens Health ; 22(1): 212, 2022 06 07.
Artículo en Inglés | MEDLINE | ID: mdl-35672816

RESUMEN

BACKGROUND: Despite being a preventable disease, cervical cancer continues to be a public health concern, affecting mainly lower and middle-income countries. Therefore, in Bogotá a home-visit based program was instituted to increase screening uptake. However, around 40% of the visited women fail to attend their Pap smear test appointments. Using this program as a case study, this paper presents a methodology that combines machine learning methods, using routinely collected administrative data, with Champion's Health Belief Model to assess women's beliefs about cervical cancer screening. The aim is to improve the cost-effectiveness of behavioural interventions aiming to increase attendance for screening. The results presented here relate specifically to the case study, but the methodology is generic and can be applied in all low-income settings. METHODS: This is a cross-sectional study using two different datasets from the same population and a sequential modelling approach. To assess beliefs, we used a 37-item questionnaire to measure the constructs of the CHBM towards cervical cancer screening. Data were collected through a face-to-face survey (N = 1699). We examined instrument reliability using Cronbach's coefficient and performed a principal component analysis to assess construct validity. Then, Kruskal-Wallis and Dunn tests were conducted to analyse differences on the HBM scores, among patients with different poverty levels. Next, we used data retrieved from administrative health records (N = 23,370) to fit a LASSO regression model to predict individual no-show probabilities. Finally, we used the results of the CHBM in the LASSO model to improve its accuracy. RESULTS: Nine components were identified accounting for 57.7% of the variability of our data. Lower income patients were found to have a lower Health motivation score (p-value < 0.001), a higher Severity score (p-value < 0.001) and a higher Barriers score (p-value < 0.001). Additionally, patients between 25 and 30 years old and with higher poverty levels are less likely to attend their appointments (O.R 0.93 (CI: 0.83-0.98) and 0.74 (CI: 0.66-0.85), respectively). We also found a relationship between the CHBM scores and the patient attendance probability. Average AUROC score for our prediction model is 0.9. CONCLUSION: In the case of Bogotá, our results highlight the need to develop education campaigns to address misconceptions about the disease mortality and treatment (aiming at decreasing perceived severity), particularly among younger patients living in extreme poverty. Additionally, it is important to conduct an economic evaluation of screening options to strengthen the cervical cancer screening program (to reduce perceived barriers). More widely, our prediction approach has the potential to improve the cost-effectiveness of behavioural interventions to increase attendance for screening in developing countries where funding is limited.


Asunto(s)
Detección Precoz del Cáncer , Neoplasias del Cuello Uterino , Adulto , Colombia , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Tamizaje Masivo , Probabilidad , Reproducibilidad de los Resultados , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control
3.
Sci Total Environ ; 838(Pt 3): 156363, 2022 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-35654187

RESUMEN

Scientific works examining coal-derived nanoparticles (NPs) containing potentially toxic elements (PTEs) confined in marine suspended sediments (MSSs) in port regions worldwide is an understudied topic, despite the fact that coal NPs have tremendous negative impacts on marine estuaries. The general objective of this study is to analyze the NP levels of coal, including PTEs, contained within MSSs in the general vicinity of the largest Caribbean port in Colombia. The morphology, size, chemical composition, and agglomeration states of NPs within MSSs of the sampled beaches were calculated through modern electron microscopy. The methodology used to detect chemical elements, unfortunately with EDS, it is not possible to precisely specify the chemical elements of low atomic weight (e.g. H, O, F, etc.) Therefore, with the EDS available today, it is only possible to have an idea of the chemical composition of each detected particle. Thus, it was possible to obtain the average frequency of the chemical elements identified in the 23 analyzed sampling points. Through the results, more than one thousand particles were detected in the most abundant phases, thus, the most frequent particles in the results of this manuscript were described. Sample point 8, located closest to the coal export port, had a higher concentration of nano-toxic elements (Al, Fe, Si, K, Mg, K) most concerning for human health in addition to being harmful to marine life. This study suggests that public policies dealing with MSS pollution need to be discussed by public managers to avoid further and sustained environmental degradation. The need to create projects will subsidize legacy liabilities generated by coal in seaports in other regions of the world.


Asunto(s)
Carbón Mineral , Nanopartículas , Carbón Mineral/análisis , Colombia , Monitoreo del Ambiente/métodos , Sedimentos Geológicos/química , Humanos
4.
Hist Cienc Saude Manguinhos ; 29(2): 461-480, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35674622

RESUMEN

This article studies the shift from a Ministry of Hygiene in Colombia to a Ministry of Public Health, from 1946 to 1953. This was not only a new name for the ministry, but a transitional process from government policies based on European public hygiene towards institutionalizing the North American model of public health. The process involved negotiations between local government representatives and the Currie Mission, which was sent to Colombia by the Inter-American Bank for Reconstruction and Development and the Inter-American Cooperative Health Service. These negotiations took place via asymmetrical relationships of interdependence, within the framework of the "invisible government" implemented by the United States in Latin America during the Cold War.


Asunto(s)
Gobierno , Salud Pública , Colombia , América Latina , Estados Unidos
5.
Molecules ; 27(11)2022 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-35684438

RESUMEN

Eleven indanoyl derivatives were synthesized and, along with methyl jasmonate, evaluated as isoflavonoid-phytoalexin elicitors in two cultivars of common bean (Phaseolus vulgaris L. cvs. ICA-Cerinza and Uribe Rosado, tolerant and susceptible to anthracnose, respectively). Indanoyl derivatives (an ester, two amides, and eight indanoyl-amino acid conjugates) were obtained from 1-oxo-indane-4-carboxylic acid. In general, the accumulation of isoflavonoid-type phytoalexins, such as isoflavones (genistein, daidzein, and 2'-hydroxygenistein), isoflavanones (dalbergioidin and kievitone), isoflavan (phaseollinisoflavan), coumestrol, and pterocarpans (phaseollidin and phaseollin), was dependent on the common bean cultivar, the post-induction time, and the elicitor structure. Isoflavones, dalbergioidin, and coumestrol reached their highest amounts during the first 48 to 72 h, whereas kievitone, phaseollinisoflavano, and the pterocarpans reached maximum levels between 72 and 96 h. The 1-oxo-indanoyl-L-isoleucine methyl ester elicited the highest levels of phytoalexins (similar to those elicited by the methyl jasmonate) and showed no significant phytotoxic effects on common bean seedlings. The indanoyl-type synthetic elicitor, 1-oxo-indanoyl-L-isoleucine methyl ester, may represent a promising agronomic alternative for disease control in common bean by enhancing the accumulation of antimicrobial isoflavonoid phytoalexins.


Asunto(s)
Isoflavonas , Phaseolus , Pterocarpanos , Colombia , Cumestrol , Isoflavonas/farmacología , Sesquiterpenos
7.
Rev Fac Cien Med Univ Nac Cordoba ; 79(2): 205-209, 2022 06 06.
Artículo en Español | MEDLINE | ID: mdl-35700468

RESUMEN

Objetive: To identify contributions of the scientific literature produced in the 2009-2019 period in Latin America on humanized prenatal care. Data sources:Articles produced in Latin America that addressed humanized prenatal care, published between 2009 and 2019 in indexed journals (reported in MIAR) and located in recognized databases, were selected. Study selection: A selection based on the source, quality and relevance of the studies was taken into account, excluding gray literature. After applying filters, 26 articles were obtained. Data extraction: The data was recorded, subsequently using an analytical matrix for its coding. Data: the studies, especially from Colombia and Brazil, were largely qualitative. It is established that the quality of care is reflected in the accessibility and satisfaction of the users with the services. Humanized prenatal care affects maternal-perinatal health. The recognition of the particular needs of pregnant women is relevant. The studies recommend qualifying health personnel to strengthen humanized prenatal care, assuming pregnant women as protagonists of the process, dispelling their doubts and concerns, and providing evidence on the relationship humanized prenatal care / reduction of maternal morbidity and mortality. Conclusions: The studies carried out recognize the pregnant woman as the protagonist and her needs as the starting point for humanized prenatal care, conceived as an essential reference for the quality of services with a positive impact on the satisfaction of pregnant women and maternal outcomes. Training of health personnel is required.


Objetivo: Identificar aportes de la literatura científica producida en el periodo 2009-2019 en América Latina sobre atención prenatal humanizada. Fuentes de datos: Se seleccionaron artículos producidos en América Latina que abordaran la atención prenatal humanizada, publicados entre 2009 y 2019 en revistas indexadas (reportadas en MIAR) y localizados en bases de datos reconocidas. Selección de los estudios: Se tuvo en cuenta una selección basada en la fuente, calidad y pertinencia de los estudios, excluyendo la literatura gris. Luego de aplicar filtros se obtuvieron 26 artículos. Extracción de datos: Los datos fueron fichados, utilizando posteriormente una matriz analítica para su codificación. Datos: los estudios, sobre todo provenientes de Colombia y Brasil, fueron en buena parte cualitativos. Se establece que la calidad de la atención se refleja en la accesibilidad y la satisfacción de las usuarias con los servicios. El cuidado prenatal humanizado incide en la salud materno-perinatal. Es relevante el reconocimiento de las necesidades particulares de las gestantes. Los estudios recomiendan cualificar el personal de salud para fortalecer el cuidado prenatal humanizado, asumir las gestantes como protagonistas del proceso, disipando sus dudas y preocupaciones y aportar evidencia sobre la relación atención prenatal humanizada/reducción de la morbimortalidad materna. Conclusiones: Los estudios realizados reconocen a la gestante como protagonista y sus necesidades como el punto de partida para la atención prenatal humanizada, concebida como referente esencial de la calidad de los servicios con impacto positivo sobre la satisfacción de las gestantes y los resultados maternos. Se requiere formar al personal de salud.


Asunto(s)
Atención Prenatal , Brasil , Colombia , Femenino , Humanos , América Latina , Embarazo , Estudios Retrospectivos
8.
AMA J Ethics ; 24(6): E483-488, 2022 Jun 01.
Artículo en Inglés, Arabe | MEDLINE | ID: mdl-35713916

RESUMEN

Clinicians in postconflict health care settings can be tasked with caring for patients who are ex-combatants. This commentary responds to a case of a health worker with duties to care for ex-Revolutionary Armed Forces of Colombia combatants. Specifically, this article considers clinical, ethical, and legal demands of reincorporating ex-combatants in compliance with a peace agreement on systems and individual health workers.


Asunto(s)
Personal Militar , Colombia , Humanos
9.
PLoS One ; 17(6): e0270086, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35714144

RESUMEN

OBJECTIVE: To estimate the economic burden of Severe Acute Respiratory Infection (SARI) in lab-confirmed influenza patients from a low-income country setting such as Colombia. METHODS: A bottom-up costing analysis, from both third payer and social perspectives, was conducted. Direct costs of care were based on the review of 227 clinical records of lab-confirmed influenza inpatients in six facilities from three main Colombian cities. Resources were categorized as: length of stay (LOS), diagnostic and laboratory tests, medications, consultation, procedures, and supplies. A survey was designed to estimate out-of-pocket expenses (OOPE) and indirect costs covered by patients and their families. Cost per patient was estimated with the frequency of use and prices of activities, calculating median and 95% confidence intervals (95% CI) with bootstrapping. Total costs are expressed as the sum of direct medical costs, OOPE and indirect costs in 2018 US dollars. RESULTS: The media direct medical cost per SARI lab-confirmed influenza patient was US$ 700 (95% CI US$ 552-809). Diagnostic and laboratory tests correspond to the highest cost per patient (37%). Median OOPE and indirect costs per patient was US$ 147 (95% CI US$ 94-202), with the highest costs for caregiver expenses (27%). Total costs were US$ 848 (95% CI US$ 646-1,011), OOPE and indirect costs corresponded to 17.4% of the total. The median of direct medical costs per patient was three times higher in elderly patients. CONCLUSION: SARI influenza costs impose a high economic burden on patients and their families. The results highlight the importance of strengthening preventive strategies nationwide in the age groups with higher occurrence and incurred health costs.


Asunto(s)
Gripe Humana , Anciano , Colombia/epidemiología , Costo de Enfermedad , Costos de la Atención en Salud , Hospitalización , Humanos , Gripe Humana/epidemiología , Estaciones del Año
10.
Rev Chilena Infectol ; 39(1): 7-13, 2022 02.
Artículo en Español | MEDLINE | ID: mdl-35735274

RESUMEN

BACKGROUND: The use of antibiotics is the main factor of microbial resistance. AIM: To determine the consumption of antibiotics in health care institutions in Santiago de Cali between 2013 and 2020. METHODS: The methodology of the Defined Daily Dose per 100 beddays was employed. Institutions that had at least 9 annual reports and that the report is greater than 95% were defined as inclusion criteria. In this case, 10 institutions were included. RESULTS: Consumption in Intensive Care Units (ICU) was higher than in other units. Ceftriaxone and imipenem were more consumed in units other than ICU, whereas meropenem, piperacillin/tazobactam and vancomycin were more consumed in the ICU. In units other than ICU, two institutions increased the consumption of ceftriaxone, ciprofloxacin and piperacillin/tazobactam and one the consumption of vancomycin, whereas in the ICU, one institution increased the consumption of piperacillin/tazobactam. The endemic range identified that vancomycin located itself in the epidemic zone in one institution. CONCLUSION: The system provided tools for prospective surveillance that showed the need for intervention in institutions.


Asunto(s)
Antibacterianos , Vancomicina , Antibacterianos/uso terapéutico , Ceftriaxona , Colombia , Unidades de Cuidados Intensivos , Pruebas de Sensibilidad Microbiana , Combinación Piperacilina y Tazobactam , Estudios Prospectivos
11.
Menopause ; 29(6): 664-670, 2022 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-35674647

RESUMEN

OBJECTIVES: To identify the frequency of clinical suspicion of sarcopenic obesity (CSSO) and probable sarcopenic obesity (PSO) and to estimate the association between them and surgical menopause. METHODS: A cross-sectional study carried out in women residing in Colombia, ages 60 to 75 years. Body mass index, the SARC-F scale, SARC-CalF < 31, and SARC-CalF <33 versions adding the calf circumference measurement in the last two were used to identify CSSO. Muscle strength measurement was added to the above measures to establish PSO. Surgical menopause was defined in women who underwent bilateral oophorectomy simultaneously with hysterectomy before natural menopause. Adjusted and unadjusted logistic regression were performed between CSSO or PSO with surgical menopause, bilateral oophorectomy after natural menopause, and abdominal hysterectomy with ovarian preservation. All participants provided informed consent. P < 0.05 was statistically significant. RESULTS: Seven hundred women 67.0 ±â€Š4.8 years old were included; 23.7% were obese, 68.1% had reduced muscle strength, and 4.2% had surgical menopause. CSSO was found in 3.0% with SARC-F and with SARC-CalF < 31; whereas 2.0% were found with SARC-CalF <33. PSO was found in 2.4%, 1.5%, and 2.2% with SARC-F, SARC-CalF <31, and SARC-CalF <33, respectively. Surgical menopause was associated with PSO but was not associated with CSSO. Bilateral oophorectomy after menopause and hysterectomy with ovarian preservation were not associated with CSSO or PSO. CONCLUSIONS: In a group of older adult women, the frequency of CSSO was up to 3.0% and PSO up to 2.4%. Surgical menopause was statistically significantly associated with PSO. On the contrary, CSSO was not associated.


Asunto(s)
Enfermedades de los Genitales Femeninos , Sarcopenia , Anciano , Colombia/epidemiología , Estudios Transversales , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/epidemiología , Sarcopenia/epidemiología , Encuestas y Cuestionarios , Síndrome
12.
Health Syst Reform ; 8(1): 2079448, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-35675560

RESUMEN

Colombia provides a unique setting to understand the complicated interaction between health systems, health insurance, migrant populations, and COVID-19 due to its system of Universal Health Coverage and its hosting of the second-largest population of displaced persons globally, including approximately 1.8 million Venezuelan migrants. We surveyed 8,130 Venezuelan migrants and Colombian nationals across 60 municipalities using a telephone survey during the first wave of the pandemic (September through November 2020). Using self-reported enrollment in one of the several Colombian health insurance schemes, we analyzed the access to and disparities in the use of health-care services for both Colombians and Venezuelan migrants by insurance status, including access to formal health services, virtual visits, and COVID-19 testing for both groups. We found that compared with 3.6% of Colombians, 73.6% of Venezuelan telephone survey respondents remain uninsured, despite existing policies that allow legally present migrants to enroll in national health insurance schemes. Enrolling migrants in either the subsidized or contributory regime increases their access to health-care services, and equality between Colombians and Venezuelans within the same insurance schemes can be achieved for some services. Colombia's experience integrating Venezuelan migrants into their current health system through various insurance schemes during the first wave of their COVID-19 pandemic shows that access and equality can be achieved, although there continue to be challenges.


Asunto(s)
COVID-19 , Migrantes , COVID-19/epidemiología , Prueba de COVID-19 , Colombia/epidemiología , Humanos , Pandemias
13.
Spat Spatiotemporal Epidemiol ; 41: 100495, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35691652

RESUMEN

The spatial distribution of surveillance-reported dengue cases and severity are usually analyzed separately, assuming independence between the spatial distribution of non-severe and severe cases. Given the availability of data for the individual geo-location of surveillance-notified dengue cases, we conducted a spatial analysis to model non-severe and severe dengue simultaneously, using a hierarchical Bayesian model. We fit a joint model to the spatial pattern formed by dengue cases as well as to the severity status of the cases. Results showed that age and socioeconomic status were associated with dengue presence, and there was evidence of clustering for overall cases but not for severity. Our findings inform decision making to address the preparedness or implementation of dengue control strategies at the local level.


Asunto(s)
Dengue , Dengue Grave , Teorema de Bayes , Colombia/epidemiología , Dengue/epidemiología , Dengue/prevención & control , Humanos
14.
Environ Monit Assess ; 194(7): 494, 2022 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-35691952

RESUMEN

The baseline values for metal(loid)s in soils are known as a tool for the evaluation, prevention, and monitoring of the environmental quality of the soil. The main aim is to propose baseline values for metal(loid)s through the analysis of the concentrations in soils within natural areas; additionally, this study attempts to assess the environmental quality of soils in agricultural areas. The study was developed in the Piedemonte Llanero from Colombia a region with more than 5000 mm year-1 of pluviometry. A total of 90 soil samples were collected in agricultural and natural areas. Chemical analysis was conducted by acid digestion following the method EPA 3050B and determined the metal(loid)s (Al, As, Fe, Cd, Cr, Cu, Mg, Mn, Ni, Pb, and Zn) through ICP-OES. This is the first time that baseline values are proposed for a region in Colombia. The values proposed (expressed in mg kg-1) are Cd (0.3), As (2.8), Cu (9.9), Ni (10.2), Pb (11.3), Cr (21.1), Zn (28.2), Mn (83.8), Mg (348), Fe (22,775), and Al (28,975). These values are comparatively lower than those reported for other regions in Latin America and the rest of the world. Also, agricultural soils are not contaminated. The possible explanation is as a consequence of the intense washing caused by the intense rainfall of the place. The results also demonstrated that the soils in this region are not contaminated. Finally, these advances will allow public and private organizations to establish criteria for the environmental and sustainable management of soils, especially on agricultural activities.


Asunto(s)
Metales Pesados , Contaminantes del Suelo , Cadmio/análisis , Colombia , Monitoreo del Ambiente/métodos , Plomo/análisis , Metales Pesados/análisis , Medición de Riesgo , Suelo , Contaminantes del Suelo/análisis
15.
Front Public Health ; 10: 840292, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35646771

RESUMEN

Introduction: For young adults, the first year of higher education represents a transition period into adulthood associated with an increased risk of developing depression, anxiety, and stress, contributing to deteriorating physical and mental health. The present study aimed to analyze the relationship between depressive symptoms and social capital and lifestyles among Colombian university students. Methods: In 2020, a longitudinal repeated measures study was conducted on first year students at Universidad de los Andes in Bogota, Colombia. The study was conceptualized and approved by the university before the COVID-19 pandemic appeared. Each student completed a self-administered questionnaire including questions on sociodemographic characteristics, depressive symptoms, perceived stress, social capital, and lifestyles. The study's pilot was conducted in November 2019, and the two measurement points were in January 2020 (wave 1, before the COVID-19 pandemic was declared) and in August 2020 (wave 2, during the COVID-19 pandemic). A binary logistic regression analysis was performed to assess the relationship between depressive symptoms, perceived stress, social capital, and lifestyles. Findings: A total of 609 first year students (response rate = 58.11%) participated in wave 1, and 42% of the participants showed signs of clinically relevant depressive symptoms. In wave 2, despite the difficulties encountered in collecting data due to the COVID-19 pandemic, 216 students from wave 1 participated (35.47%). An increase in a sedentary lifestyle was observed (31.49%). We found that cognitive and behavioral social capital levels decreased by 12.03 and 24.54%, respectively. In addition, we observed a 6.5% increase in students with clinically relevant depressive symptoms compared to wave 1. A low level of behavioral [OR: 1.88; 95% CI (1.16, 3.04)] social capital was associated with clinically relevant depressive symptoms. Conclusion: The health of university students continues to be a public health concern. The study suggests that social capital may play an important role in preventing depressive symptoms. Therefore, universities should put effort into programs that bring students together and promote the creation of social capital.


Asunto(s)
COVID-19 , Capital Social , Adulto , COVID-19/epidemiología , Colombia/epidemiología , Depresión/psicología , Humanos , Estilo de Vida , Salud Mental , Pandemias , Estudiantes/psicología , Universidades , Adulto Joven
16.
Cien Saude Colet ; 27(6): 2325-2336, 2022 Jun.
Artículo en Español | MEDLINE | ID: mdl-35649020

RESUMEN

The association between income inequality and dental caries on early childhood in Colombia was evaluated using a multi-level analysis. We analyzed data from the latest national oral survey (2014) and information about income in absolute and relative terms on a state-level. The outcomes were caries experience, and untreated caries. A multilevel logistic regression model was used (2 levels) with children/households nested within states. Age, gender, area-level socioeconomic position (SEP), household income and health insurance regime were the level 1 explanatory variables. For level 2, variables were the Gini coefficient, Unsatisfied Basic Needs (UBN) and Gross Domestic Product (GDP). Data from 5.250 children, aged 1, 3 and 5 years were evaluated. Prevalence of caries experience and untreated caries was 36.9% and 33.0% respectively. Both outcomes showed significant associations with age, low SEP and belonging to the subsidized health insurance regime: untreated dental caries was associated with living in low and very low SEP (OR: 1.72; 95%CI 1.42, 2.07 and OR: 1.69; 95%CI 1.36, 2.09 respectively), and subsidized health insurance scheme (OR: 1.58; 95%CI 1.11, 2.24). When the Gini, GDP and UBN indicators were included in the models, no significant associations were found.


Evaluamos la asociación entre inequidad en los ingresos y caries de la infancia temprana en Colombia, utilizando un análisis multinivel. Analizamos datos del último estudio nacional de salud bucal (2014) e información sobre ingresos en términos absolutos y relativos a nivel departamental. Los desenlaces fueron experiencia de caries y caries no tratada. Se utilizó un modelo de regresión logística multinivel con dos niveles: niños/familias (nivel 1) anidados en departamentos (nivel 2). En el nivel 1 se consideraron variables de edad, sexo, posición socioeconómica (PSE) de la vivienda, ingresos del hogar y régimen de aseguramiento en salud. Para el nivel 2 las variables fueron coeficiente Gini, Necesidades Básicas Insatisfechas (NBI) y Producto Interno Bruto (PIB). Se evaluaron datos de 5.250 niños de 1, 3 y 5 años, 36.9% tenían experiencia de caries y 33.0% caries no tratada. Los desenlaces mostraron asociaciones significativas con edad, PSE baja del hogar y pertenecer al régimen subsidiado de salud. Para caries no tratada se encontraron asociaciones con PSE baja o muy baja (OR: 1.72; IC95% 1.42, 2.07 y OR: 1.69; IC95% 1.36, 2.09 respectivamente) y régimen subsidiado de salud (OR: 1.58; IC95% 1.11, 2.24). No se encontraron asociaciones significativas con indicadores de coeficiente Gini, PIB y NBI.


Asunto(s)
Caries Dental , Niño , Preescolar , Colombia/epidemiología , Caries Dental/epidemiología , Susceptibilidad a Caries Dentarias , Humanos , Renta , Análisis Multinivel
17.
Health Syst Reform ; 8(1): e2064793, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-35666239

RESUMEN

A major theoretical issue about health system reform involving decentralization has been whether it promotes equity of health system funding. An article by the principal author and others in 2003 showed that, under certain conditions and policies, decentralization improved the equity of allocation of financial resources to different income levels of municipalities in Colombia and Chile. Another recurring issue has been whether reforms can be sustained over time. In a follow-up study in 2015, we found that the equity of national allocations was sustained even though the allocation rules for intergovernmental transfers and insurance funding sources had changed, as long as per capita allocation rules were retained. Nevertheless, the wealthier municipalities in Chile were able to increase their own source funding contributing to a larger gap between wealthy and poor municipalities, suggesting that in order to assure continued equity some compensation for these funds be included in intergovernmental transfer rules or that local source funding be restricted by national policy. These reforms may be more likely to be sustained if they become embedded in existing financial systems and if they receive support of status quo constituencies.


Asunto(s)
Financiación de la Atención de la Salud , Política , Chile , Colombia , Estudios de Seguimiento , Humanos
18.
BMJ Open ; 12(6): e058198, 2022 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-35667729

RESUMEN

OBJECTIVES: Value-based healthcare (VBHC) is a health system reform gradually being implemented in health systems worldwide. A previous national-level survey has shown that Latin American countries were in the early stages of alignment with VBHC. Data at the healthcare provider organisations (HPOs) level are lacking. This study aim was to investigate how HPOs in five Latin American countries are implementing VBHC. DESIGN: Mixed-methods research was conducted using online questionnaire, semistructured interviews based on selected elements of the value agenda (from December 2018 to June 2020), analyses of aggregated data and documents. Qualitative analysis was performed using NVivo QSR International, 1.6.1 (4830). Quantitative analysis used Fisher's exact test. Univariate analysis was used to compare organisations in relation to the implementation of VBHC initiatives. A p≤0.05 was considered significant. PARTICIPANTS: Top and middle-level executives from 70 HPOs from Argentina, Brazil, Chile, Colombia and Mexico. RESULTS: The definition of VBHC varied across participating organisations. Although the value equation had been cited by 24% of participants, its composition differed in most case from the original Equation. Most VBHC initiatives were related to care delivery organisation (56.9%) and outcomes measurement (22.4%) but in most cases, integrated practice unit features had not been fully developed and outcome data was not used to guide improvement. Information, stakeholders buy-in, compensation and fragmented care delivery were the most cited challenges to VBHC implementation. Fee-for-service predominated, although one-third of organisations were experimenting with alternative payment models. CONCLUSIONS: A wide variation in the definition and level of VBHC implementation existed across organisations. Our finding suggests investments in information systems and on education of key stakeholders will be key to foster VBHC implementation in the region. Further research is needed to identify successful implementation cases that may serve as regional benchmark for other Latin American organisations advancing with VBHC.


Asunto(s)
Atención a la Salud , Personal de Salud , Argentina , Brasil , Chile , Colombia , Humanos , América Latina , México , Encuestas y Cuestionarios
19.
Trop Anim Health Prod ; 54(4): 200, 2022 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-35668244

RESUMEN

The Blanco Orejinegro (BON) is a Colombian creole cattle breed that is not genetically well characterized for growth traits. The aim of this work was to estimate genetic parameters for birth weight (BW), weaning weight (WW), yearling weight (YW), daily weight gain between birth and weaning (DWG), time to reach 120 kg of live weight (T120), and time to reach 60% of adult weight (T60%), and establish the selection criteria for growth traits in the BON population of Colombia. Genealogical and phenotypic information for BW, WW, YW, DWG, T120, and T60% traits of BON animals from 14 Colombian herds were used. These traits were analyzed with the AIREML method in a uni- and bi-trait animal model including the maternal effect for BW, WW, DWG, and T120. The direct heritability estimates values were 0.22 ± 0.059 (BW), 0.20 ± 0.057 (WW), 0.20 ± 0.153 (YW), 0.17 ± 0.07 (DWG), 0.26 (T120), and 0.44 ± 0.03 (T60%). The maternal heritability estimates values were 0.14 ± 0.040 (BW), 0.15 ± 0.039 (WW), 0.25 ± 0.06 (DWG), and 0.16 (T120). The direct genetic correlations were high ( >|0.60|) among all the traits, except between T60% with BW, WW, YW, and DWG (ranged from - 0.02 to - 0.51), all in a favorable direction. The results showed that there is genetic variation in the growth traits associated with the additive genetic effect, and they might respond to selection processes. Furthermore, genetic gains would improve through selection, especially for YW and T60% when WW is used as criterion.


Asunto(s)
Herencia Materna , Animales , Peso al Nacer/genética , Peso Corporal , Bovinos/genética , Colombia , Fenotipo , Destete
20.
Medwave ; 22(5): e8743, 2022 Jun 15.
Artículo en Español, Inglés | MEDLINE | ID: mdl-35704901

RESUMEN

Atrioventricular blocks are chronotropic abnormalities produced by multifactorial alterations in the cardiac innervation system, specifically between the internodal pathways between the sinus node and the atrioventricular node. These bradyarrhythmias represent 2.3% of cardiac alterations in intrauterine life, registering one case for every 20 000 to 25 000 live births. However, its occurrence in childhood and adolescence is unknown. Likewise, the percentage of idiopathic atrioventricular blocks in this group in Colombia is unknown to date. Among the possible etiol-ogies, congenital and acquired causes have been documented. Some examples are isolated cases found in pregnancies with maternal isoimmunization, from carriers with lupus, and in coexis-tence with structural alterations, such as anomalies of the interventricular septum due to cardiac tumors and defects in the ostium and septation of the cardiac chambers. Atrioventricular blocks are also associated with respiratory syncytial virus infection and concomitant viral myocarditis and with cardiomyopathies of immune, rheumatic, infectious, tumoral, and structural origin, in addition to mitochondrial diseases such as Kearns Sayre syndrome, presenting with multi- organ involvement. These etiologies lead to chronic inflammation with fibrotic repair in the cardiac conduction system, which alters the transmission of the action potential and bradycardia with atrioventricular asynchrony. Idiopathic causes described in the onset of primary dysautonomia have also been reported. We present the case of an 11- year- old patient with a headache crisis and paroxysmal vegetative symptoms associated with repeated fainting, with subsequent studies where no structural alterations or autoimmune findings were identified. The patient was diag-nosed with idiopathic complete atrioventricular block and received expectant management by the electrophysiology service.


Los bloqueos auriculoventriculares son aberraciones cronotrópicas producidas por alteraciones de índole multifactorial en el sistema de inervación cardíaco. Específicamente se localizan entre las vías internodales que conducen el potencial de acción desde el nodo sinusal hasta el nodo auriculoventricular. Estos representan el 2,3% de las alteraciones cardíacas en la vida intrauterina, registrándose un caso por cada 20 000 a 25 000 nacidos vivos. Sin embargo, su ocurrencia en la infancia temprana y la edad escolar es desconocida. Asimismo, el porcentaje de causas idiopáticas de bloqueos auriculoventriculares en esta etapa de la vida es desconocido hasta el momento en Colombia. Dentro de las posibles etiologías se han documentado causas congénitas y adquiridas. Algunos ejemplos son casos aislados producto de isoinmunización materna, en hijo de madre lúpica o en coexistencia con alteraciones estructurales como anomalías del septo interventricular de índole neoplásico, defectos relacionados al ostium y la tabicación de las cámaras cardíacas. También se han descrito casos secundarios a infección por virus sincitial respiratorio y miocarditis vírica concomitante, incluyendo cardiomiopatías de origen inmune, reumático, infeccioso, tumoral, estructural, además de aquellas con compromiso mitocondrial en el cardiomiocito (síndrome de Kearns Sayre) con presentación más tardía con afectación multiorgánica. Todas ellas destacan por un fenómeno en común a nivel celular, referente a la inflamación crónica con reparación fibrótica en el sistema de conducción cardíaco, que conlleva alteraciones de la transmisión del potencial de acción y bradicardia con asíncrona auriculoventricular. También se han reportado causas idiopáticas descritas en el debut de una disautonomía primaria. Se presenta el caso de una paciente de 11 años con crisis de cefalea y síntomas vegetativos paroxísticos asociados a lipotimias a repetición, con posteriores estudios de extensión sin identificación de alteraciones estructurales ni hallazgos autoinmunes. A la niña se le diagnosticó bloqueo auriculoventricular completo, idiopático por lo que recibió manejo expectante por parte del servicio de electrofisiología.


Asunto(s)
Bloqueo Atrioventricular , Adolescente , Bloqueo Atrioventricular/complicaciones , Niño , Colombia , Electrocardiografía , Humanos
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