Increased threat of urban arboviral diseases from Aedes aegypti mosquitoes in Colombia.

Objectives: Our study targets the potential of the local urban mosquito Aedes aegypti to experimentally transmit chikungunya virus (CHIKV), dengue virus (DENV), yellow fever virus (YFV), and Zika virus (ZIKV). Methods: We collected eggs and adults of Ae. aegypti in Medellín, Colombia (from February to March 2020) for mosquito experimental infections with DENV, CHIKV, YFV and ZIKV and viral detection using the BioMark Dynamic arrays system. Results: We show that Ae. aegypti from Medellín was more prone to become infected, to disseminate and transmit CHIKV and ZIKV than DENV and YFV. Conclusions: Thus, in Colombia, chikungunya is the most serious threat to public health based on our vector competence data.

Dietary Patterns and Anti-Flavivirus IgG Seroconversion in Colombian Children.

The burden of flaviviral infections, especially dengue and Zika, is high in the Americas. Malnutrition affects the risk and response to infections, but the role of diet on flaviviral infection risk is uncertain. The objective of this study was to investigate the relations between dietary patterns adherence and anti-flavivirus IgG seroconversion in children during a Zika epidemic in a dengue-endemic area of Colombia. In 2015-2016, we followed 424 anti-flavivirus IgG seronegative children aged 2 to 12 years for 1 year. Baseline data included children's sociodemographic, anthropometric, and dietary information collected through a 38-item food frequency questionnaire (FFQ). IgG testing was repeated at the end of follow-up. The primary exposure was adherence to each of four dietary patterns (animal foods, traditional, ultraprocessed foods, and prudent) that were identified from the FFQ through principal component analysis. Secondary exposures were intake frequencies of foods contributing to relevant patterns. We estimated risk of seroconversion by quartiles of adherence scores and compared them using relative risks (RR) and 95% CI from Poisson regression adjusted for sex, age, and socioeconomic status indicators. Seroconversion risk was 32.1%. Adherence to the traditional pattern was positively related to seroconversion. RR comparing fourth versus first quartiles of adherence was 1.52 (95% CI: 1.04-2.21; P trend = 0.02). Of the most representative foods in this pattern, potato and sugarcane water intake frequencies were related to increased seroconversion risk. In conclusion, adherence to a traditional foods pattern, including potatoes and sugarcane water, was positively associated with anti-flavivirus IgG seroconversion.

Neurodevelopmental outcome of infants without central nervous system anomalies born to symptomatic RT-PCR ZIKV positive women.

An epidemic of Zika virus (ZIKV) infection began in Colombia in October 2015. Previous studies have identified a cause-effect relationship between fetal exposure to the ZIKV and the development of microcephaly and other central nervous system (CNS) anomalies with variable degrees of neurodevelopmental delay. Less is known about the neurodevelopmental outcome of infants without CNS anomalies born to symptomatic ZIKV RT-PCR-positive women. We aimed to compare the neurodevelopmental outcome of these infants to a control group of infants without CNS anomalies born to asymptomatic ZIKV RT-PCR negative women who did not seroconvert during pregnancy. Participating infants were categorized according to ZIKV maternal exposure. Women with symptomatology suggestive of ZIKV infection and a positive RT-PCR for ZIKV were categorized as ZIKV-exposed. Maternal controls (ZIKV unexposed) from the same geographic area were subsequently captured during the tail end of the epidemic through a partner project, the ZIKAlliance, whose aim was to determine the prevalence of ZIKV in pregnant women. Infant survivors from these two groups of pregnant women had a neurodevelopmental evaluation at 12, 18, and 24 months corrected age (CA). The ZIKV-exposed women were found to be older, had less subsidized health care, had a higher percentage of women in middle-class socioeconomic strata, had higher technical and university education, were less likely to be living with a partner, and had higher rates of pregnancy comorbidity and premature births than ZIKV unexposed women. Compared to infants born to ZIKV unexposed women (unexposed), infants born to ZIKV exposed women (exposed) were of lower gestational age and required more speech and occupational therapy services. No differences between groups were observed in the proportion of cut-off scores <70 on the Bayley-III Scale at 12, 18, and 24 months for motor, language, and cognitive domains. When a cut-off of <85 was used, a higher percentage of motor and cognitive impairment was observed in unexposed infants at 12 and 24 months CA, respectively. Median and IQR score on the Bayley-III scale showed higher scores in favor of exposed infants for motor development at 12 and 18 months CA, language at 12 months, and cognitive domain at 12, 18, and 24 months. The adjusted median and IQR compound score of the difference between exposed and unexposed was higher in favor of exposed infants at 12 to 24 months CA for motor (3.8 [95% CI 1.0 to 6.7]) and cognitive domains (10.6 [95% CI 7.3 to 13.9]). We observed no differences in the language domain (1.9 [95% CI -1.2 to 5.0]). We conclude that infants with no evidence of microcephaly or other CNS anomalies born to ZIKV-exposed women had normal neurodevelopment up to 24 months of CA, supporting an all-or-nothing effect with maternal ZIKV exposure. Long-term follow-up to evaluate school performance is required. Clinical Trial Registration: www.clinicaltrials.gov, NCT02943304.

Seroprevalence of anti-SARS-CoV-2 antibodies in Colombia, 2020: A population-based study.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause very high morbidity and mortality throughout Latin American countries. However, few population-based seroprevalence surveys have been conducted to quantify attack rates and characterize drivers of transmission. METHODS: We conducted a population-based cross-sectional study to assess the seroprevalence of antibodies against SARS-CoV-2 in ten cities in Colombia between September and December 2020. The study involved multi-stage cluster sampling at each city. Participants provided a serum sample and answered a demographic and risk factor questionnaire. Prior infection by SARS-CoV-2 was ascertained using the "SARS-CoV-2 Total (COV2T) Advia Centaur - Siemens" chemiluminescence assay. FINDINGS: A total of 17863 participants from 7320 households participated in the study. Seroprevalence varied substantially between cities, ranging from 26% (95%CI 23-29 %) in Medellín to 68% (95%CI 62-74 %) in Guapi. There were no differences in seroprevalence by sex, but seropositivity was higher in certain ethnic groups. There was substantial heterogeneity in seroprevalence within cities, driven to a large extent by a strong association between socioeconomic stratum and seropositivity. INTERPRETATION: Colombia has been one of the Latin American countries most affected by the COVID-19 pandemic. This study documented very high attack rates in several Colombian cities by the end of 2020 and identified key drivers of heterogeneities including ethnicity and socioeconomic stratum. Few studies of seroprevalence of SARS-CoV-2 have been conducted in Latin America, and therefore this study contributes to the fundamental understanding of the pandemic in the region. FUNDING: The study was sponsored by, Ministerio de Ciencia y Tecnología e Innovación -CT361/2020, Ministerio de Salud y Protección Social, Fundación Universitaria del Norte, Imperial College of London, Universidad Nacional de Colombia (Sede Medellín), Universidad de Córdoba, California University, Unidad Nacional de Gestión del Riesgo, Centro de Atención y Diagnóstico de Enfermedades Infecciosas -CDI-, Centro Internacional de Entrenamiento e Investigaciones Médicas -CIDEIM-, Departamento Administrativo Nacional de Estadística - DANE, Fondo Nacional de Turismo -FONTUR-, Secretarías de Salud Departamentales, Distritales y Municipales and Instituto Nacional de Salud.

Efeito de uma intervenção com a terapia comunitária integrativa na autoestima e na autoeficácia de usuários de substâncias psicoativas / Efecto de una intervención con terapia comunitaria integrativa sobre la autoestima y la autoeficacia de los usuarios de sustanciaspsicoactivas / Effect of intervention with integrative community therapy on self-estems and selfefficacy of psychoactive substance users

El objetivo de este estudio fue evaluar el efecto de un programa de intervenciónde Terapia Comunitaria Integrativa (TCI) sobre la autoestima y la autoeficacia de losusuarios de sustancias psicoactivas. Se trata de un estudio de intervención cuasiexperimental, realizado con 21 reclusos de tres comunidades terapéuticas en la región delValle de Araguaia, que se sometieron a seis ruedas de TCI en la primera mitad de 2018.La recopilación se realizó en tres etapas, utilizando un cuestionario semiestructurado, laEscala de autoestima de Rosenberg y la Escala de autoeficacia general percibida, evaluadamediante un método estadístico no paramétrico. Los resultados revelaron que la edadpromedio de los participantes fue de 37.57 años, siendo hombres marrones y soltero. Eluso de las TCI ayudó a mejorar los niveles de autoestima y autoeficacia en comparacióncon la etapa inicial (p=0.002; p=0.003). Se concluyó que el uso de las TCI tuvo efectospositivos sobre la autoestima y la autoeficacia, señalando que es una tecnologíaimportante y asequible para el cuidado de la salud que debe incluirse en el plan terapéuticode estos usuarios.(AU)

The objective of this study was to evaluate the effect of an Integrative CommunityTherapy (TCI) intervention program on the self-esteem and self-efficacy of psychoactivesubstance users. This is a quasi-experimental intervention study, conducted with 21inmates from three therapeutic communities in the Araguaia Valley region, whounderwent a six TCI wheels in the first half of 2018. The collection took place in threestages, using a semi-structured questionnaire, the Rosenberg Self-Esteem Scale and thePerceived General Self-Efficacy Scale, evaluated by non-parametric statistical method.The results revealed that the average age of the participants was 37.57 years, being brownand single. The use of TCI helped to improve their self-esteem and self-efficacy levelswhen compared to the initial stage (p=0.002; p=0.003). Is was concluded that the use ofTCI had positive effects on self-esteem and self-efficacy, pointing it as an important,affordable and affordable health care technology that should be included in thetherapeutic plan of these users.(AU)

Objetivou avaliar o efeito de um programa de intervenção com a TerapiaComunitária Integrativa (TCI) na autoestima e na autoeficácia de usuários de substânciaspsicoativas. Trata-se de um estudo de intervenção quase-experimental, realizado com 21internos de três comunidades terapêuticas na região do Vale do Araguaia, submetidos aseis rodas de TCI no primeiro semestre de 2018. A coleta ocorreu em três etapas,utilizando um questionário semiestruturado, a Escala de Autoestima de Rosenberg e aEscala de Autoeficácia Geral Percebida, avaliados por método estatístico não-paramétricos. Os resultados revelaram que a média de idade dos participantes foi de 37,57anos, sendo homens pardos e solteiros. O uso da TCI auxiliou os usuários na melhora dosníveis de autoestima e autoeficácia quando comparado a etapa inicial (p=0,002; p=0,003).Conclui-se que o uso da TCI apresentou efeitos positivos sobre a autoestima e aautoeficácia, apontando-a como uma importante tecnologia do cuidado em saúde,acessível e de baixo custo, que deve ser inserida no plano terapêutico desses usuários.(AU)

Illness Process and Recovery From the Perspective of the Alcoholic Patient.

The aim of this work was to gain understanding, using the self-transcendence theory, of the perspective of the alcoholic patient. This was a qualitative study using the grounded theory method. Eight semistructured interviews were conducted with alcohol-dependent individuals. Eleven categories emerged that allowed for understanding the process of becoming alcohol dependent to later seeking help and maintaining abstinence through the intervention program developed by Alcoholics Anonymous.

Custo-consumo de bebidas alcoólicas entre homens e mulheres em uma região da amazónia legal

RESUMO Objetivo: Investigar o custo-consumo de bebidas alcoólicas entre homens e mulheres em uma região da Amazônia Legal. Material e Método: Estudo exploratório e com abordagem mista, realizado em bairros de periferia de uma região da Amazônia Legal, nos meses de agosto a dezembro de 2019, junto a consumidores de bebidas álcoolicas, totalizando 60 participantes. Aplicou um roteiro semiestruturado e o Alcohol Use Disorders Identification Test. Utilizou-se o discurso do sujeito coletivo, e análise de correlação "Coeficiente de Contingência C". Respeitou todos os aspectos éticos em pesquisa. Resultados: Predominou mulheres com consumo de risco e homens em dependência química. Observou-se uma forte associação do teor alcoólico (C= 0,481; p= 0,0004) e preço da bebida (C= 0,386; p= 0,0197) com todos os tipos de padrão de uso de álcool. Para todos os homens, o teor alcoólico influencia o consumo, assim como o preço das bebidas. Entre as mulheres, sendo distinto somente o teor alcoólico. Conclusão: Esses achados apontam que os aspectos que determinam o custo-consumo são importantes elementos para fundamentar políticas públicas voltadas ao cuidado de pessoas em risco ou na condição de dependência de álcool.

ABSTRACT Objective: To investigate the cost-consumption of alcoholic beverages among men and women in a region of the Brazil's Legal Amazon. Material and Method: Exploratory study with a mixed approach, carried out in neighborhoods on the periphery of a region of the Legal Amazon, from August to December 2019, with consumers of alcoholic beverages, totaling 60 participants. A semi-structured script and the Alcohol Use Disorders Identification Test was applied. The collective subject discourse and the correlation analysis "Contingency Coefficient C" were used. All ethical aspects of the research were respected. Results: There was a predominance of women at risk of consumption and men in chemical dependency. There was also a strong association between alcohol content (C= 0.481; p= 0.0004) and beverage price (C= 0.386; p= 0.0197) with all types of alcohol consumption patterns. For all men, the alcohol content has an effect on consumption, as well as on the price of beverages. Among women, only the alcohol content varies. Conclusion: These findings point out that the aspects that determine cost-consumption are important elements to promote public policies aimed at assisting people at risk or affected by alcohol dependence.

RESUMEN Objetivo: Investigar el costo-consumo de bebidas alcohólicas entre hombres y mujeres en una región de la Amazonia Legal. Material y Método: Estudio exploratorio con enfoque mixto, realizado en barrios de la periferia de una región de la Amazonía Legal, de agosto a diciembre de 2019, con consumidores de bebidas alcohólicas, totalizando 60 participantes. Se aplicó un guión semiestructurado y el Alcohol Use Disorders Identification Test. Se utilizó el discurso del sujeto colectivo y el análisis de correlación "Coeficiente de contingencia C". Se respetaron todos los aspectos éticos en la investigación. Resultados: hubo predominio de mujeres en riesgo de consumo y hombres en dependencia química. Hubo una fuerte asociación del contenido de alcohol (C= 0,481; p= 0,0004) y el precio de la bebida (C= 0,386; p= 0,0197) con todos los tipos de patrones de consumo de alcohol. Para todos los hombres, el contenido de alcohol influye en el consumo, así como en el precio de las bebidas. Entre las mujeres, solo el contenido de alcohol es distinto. Conclusión: Estos hallazgos señalan que los aspectos que determinan el costo-consumo son elementos importantes para sustentar las políticas públicas dirigidas a la atención de personas en riesgo o en condición de dependencia del alcohol.

Serotype-specific detection of dengue viruses in a nonstructural protein 1-based enzyme-linked immunosorbent assay validated with a multi-national cohort.

BACKGROUND: Dengue virus (DENV) infections pose one of the largest global barriers to human health. The four serotypes (DENV 1-4) present different symptoms and influence immune response to subsequent DENV infections, rendering surveillance, risk assessments, and disease control particularly challenging. Early diagnosis and appropriate clinical management is critical and can be achieved by detecting DENV nonstructural protein 1 (NS1) in serum during the acute phase. However, few NS1-based tests have been developed that are capable of differentiating DENV serotypes and none are currently commercially available. METHODOLOGY/PRINCIPLE FINDINGS: We developed an enzyme-linked immunosorbent assay (ELISA) to distinguish DENV-1-4 NS1 using serotype-specific pairs of monoclonal antibodies. A total of 1,046 antibodies were harvested from DENV-immunized mice and screened for antigen binding affinity. ELISA clinical performance was evaluated using 408 polymerase chain reaction-confirmed dengue samples obtained from patients in Brazil, Honduras, and India. The overall sensitivity of the test for pan-DENV was 79.66% (325/408), and the sensitivities for DENV-1-4 serotyping were 79.1% (38/48), 80.41% (78/97), 100% (45/45), and 79.6% (98/123), respectively. Specificity reached 94.07-100%. SIGNIFICANCE: Our study demonstrates a robust antibody screening strategy that enabled the development of a serotype NS1-based ELISA with maximized specific and sensitive antigen binding. This sensitive and specific assay also utilized the most expansive cohort to date, and of which about half are from Latin America, a geographic region severely underrepresented in previous similar studies. This ELISA test offers potential enhanced diagnostics during the acute phase of infection to help guide patient care and disease control. These results indicate that this ELISA is a promising aid in early DENV-1-4 diagnosis and surveillance in regions of endemicity in addition to offer convenient monitoring for future vaccine interventions.

Demandas y estrategias para el enfrentamiento a la dependencia química reveladas en la Terapia Comunitaria Integrativa / Demandas e estratégias para o enfrentamento da dependência química reveladas na Terapia Comunitária Integrativa / Demands and strategies for coping with chemical dependence revealed in Integrative Community Therapy

RESUMEN Introducción: Este trabajo tiene como objetivo evaluar las principales demandas y estrategias reveladas por los usuarios de sustancias psicoactivas durante la ejecución de un programa de intervención con Terapia Comunitaria Integrativa. Método: Este es un estudio documental, retrospectivo y cualitativo, realizado sobre la base de las formas de evaluación y cierre de las ruedas de la Terapia Comunitaria Integrativa llevadas a cabo entre enero y mayo de 2018, en tres instituciones de recuperación de la dependencia química en el Valle del Araguaia, Brasil. El análisis de contenido se utilizó en la modalidad temática. Resultados: Las principales demandas se refieren al contexto familiar, sufrimiento e incomodidad. Las estrategias más utilizadas para hacer frente a la drogadicción fueron: autoestima, manejo de sentimientos negativos, vínculos sociales y religiosidad. Los registros señalaron que la Terapia Comunitaria Integrativa permitió un espacio para escuchar, manifestar y compartir el sufrimiento, ayudando en el proceso terapéutico y la atención de estos usuarios. Discusión: Los registros permitieron inferir los efectos beneficiosos de la participación en las ruedas de TCI, particularmente al acoger las demandas de los participantes, en el despertar de los mecanismos para hacer frente a la adversidad, dándoles la oportunidad de redimensionar sus conflictos, sufrimientos y emociones.

RESUMO Introdução: Este trabalho tem como objetivo avaliar as principais demandas e estratégias reveladas por usuários de substâncias psicoativas durante a execução de um programa de intervenção com a Terapia Comunitária Integrativa. Método: Trata-se de um estudo documental, retrospectivo e qualitativo, realizado a partir das fichas de apreciação e fechamento das rodas de Terapia Comunitária Integrativa realizadas entre janeiro a maio de 2018, em três instituições de recuperação de dependência química no Vale do Araguaia, Brasil. Utilizou-se a análise de conteúdo, na modalidade temática. Resultados: As principais demandas se referem ao contexto familiar, sofrimentos e desconfortos. As estratégias mais utilizadas no enfrentamento da dependência química foram: autoestima, manejo de sentimentos negativos, vínculos sociais e religiosidade. Os registros apontaram que a Terapia Comunitária Integrativa possibilitou espaço de escuta, manifestação e partilha de sofrimentos, auxiliando no processo terapêutico e cuidado desses usuários. Discussão: Os registros permitiram inferir os efeitos benéficos da participação nas rodas de TCI, particularmente no acolhimento das demandas dos participantes, despertando os mecanismos para enfrentar as adversidades, dando-lhes a oportunidade de redimensionar seus conflitos, sofrimentos e emoções.

ABSTRACT Introduction: This work has as objective to evaluate the main demands and strategies revealed by users of psychoactive substances during the execution of an intervention program with Integrative Community Therapy. Method: This is a documentary study, retrospective and qualitative, carried out based on the forms of assessment and closure of the Integrative Community Therapy rounds carried out between January and May 2018, in three institutions for recovery of chemical dependency in the Araguaia Valley, Brazil. Content analysis was used in the thematic modality. Results: The main demands refer to the family context, suffering and discomfort. The most used strategies for coping with chemical dependency were: self-esteem, handling of negative feelings, social bonds and religiosity. The records pointed out that the Integrated Community Therapy allowed space for listening, manifesting and sharing suffering, helping in the therapeutic process and care of these users. Disscusion: The evidence allowed inferring the beneficial effects of the participation in the Integrated Community Therapy, particularly when collecting the participants' demands, in the awakening of the mechanisms to face adversity, giving them the opportunity to re-dimension their conflicts, sufferings and emotions.

Comparative transcriptomic analysis reveals novel roles of transcription factors and hormones during the flowering induction and floral bud differentiation in sweet cherry trees (Prunus avium L. cv. Bing).

In sweet cherry trees, flowering is commercially important because the flowers, after fertilization, will generate the fruits. In P. avium, the flowering induction and flower organogensis are the first developmental steps towards flower formation and they occur within specialized organs known as floral buds during the summer, nine months before blooming. During this period the number of floral buds per tree and the bud fruitfulness (number of flowers per bud) are stablished affecting the potential yield of orchards and the plant architecture. The floral bud development is sensitive to any type of stress and the hotter and drier summers will interfere with this process and are calling for new adapted cultivars. A better understanding of the underlying molecular and hormonal mechanisms would be of help, but unlike the model plant Arabidopsis, very little is known about floral induction in sweet cherry. To explore the molecular mechanism of floral bud differentiation, high-throughput RNA sequencing was used to detect differences in the gene expression of P. avium floral buds at five differentiation stages. We found 2,982 differentially expressed genes during floral bud development. We identified genes associated with floral initiation or floral organ identity that appear to be useful biomarkers of floral development and several transcription factor families (ERF, MYB, bHLH, MADS-box and NAC gene family) with novel potential roles during floral transition in this species. We analyzed in deep the MADS-box gene family and we shed light about their key role during floral bud and organs development in P. avium. Furthermore, the hormonal-related signatures in the gene regulatory networks and the dynamic changes of absicic acid, zeatin and indolacetic acid contents in buds suggest an important role for these hormones during floral bud differentiation in sweet cherry. These data provide a rich source of novel informacion for functional and evolutionary studies about floral bud development in sweet cherry and new tools for biotechnology and breeding.

Genetic risk for dengue hemorrhagic fever and dengue fever in multiple ancestries.

BACKGROUND: Genetic risk factors for dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) and dengue fever (DF) are limited, in particular there are sparse data on genetic risk across diverse populations. METHODS: We conducted a genome-wide association study (GWAS) in a derivation and validation sample of 7, 460 participants of Latin American, South Asian, and South East Asian ancestries. We then developed a weighted polygenic risk score (PRS) for each participant in each of the validation cohorts of the three ancestries to predict the risk of DHF/DSS compared to DF, DHF/DSS compared to controls, and, DF compared to controls. FINDINGS: The risk of DHF/DSS was significantly increased, odds ratio [OR] 1.84 (95%CI 1.47 to 2.31) (195 SNPs), compared to DF, fourth PRS quartile versus first quartile, in the validation cohort. The risk of DHF/DSS compared to controls was increased (OR=3.94; 95% CI 2.84 to 5.45) (278 SNPs), as was the risk of DF compared to controls (OR=1.97; 95%CI 1.63 to 2.39) (251 SNPs). Risk increased in a dose-dependent manner with increase in quartiles of PRS across comparisons. Significant associations persisted for PRS built within ancestries and applied to the same or different ancestries as well as for PRS built for one outcome (DHF/DSS or DF) and applied to the other. INTERPRETATION: There is a strong genetic effect that predisposes to risk of DHF/DSS and DF. The genetic risk for DHF/DSS is higher than that for DF when compared to controls, and this effect persists across multiple ancestries.

A terapia comunitária integrativa no cuidado em saúde mental: revisão integrativa / Integrative community therapy in mental health care: an integrative review / La terapia comunitaria integrativa para el cuidado de la salud mental: revisión integrativa

Objetivo: Investigar a produção científica acerca do uso da terapia comunitária integrativa no cuidado em saúde mental. Métodos: Trata-se de uma revisão integrativa da literatura científica realizada em novembro de 2019, com as publicações dos últimos 13 anos, nas bases: Base de Dados de Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e Scientific Eletronic Library Online. Resultados: Foram encontrados 9.382 artigos, sendo 17 inclusos neste estudo. As principais demandas acolhidas nas rodas de terapia comunitária integrativa estiveram relacionadas com os conflitos familiares, os sentimentos negativos, as perdas, os problemas de saúde e a violência. Com relação às contribuições, participar das rodas proporcionou aos usuários autonomia, aceitação, empoderamento, resiliência e o autocuidado. Conclusão: As evidências apontaram que a terapia comunitária integrativa foi utilizada como estratégia de cuidado das demandas em saúde mental em diversos cenários, destacando-a como uma tecnologia leve, a ser aplicada coletivamente na comunidade.

Objective: To investigate scientific production about the use of integrative community therapy in mental health care. Methods: This is an integrative review of the scientific literature carried out in November 2019, with publications from the last 13 years, based on Nursing Database, Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online and Scientífic Electronic Library Online. Results: 9.382 articles were found, 17 of which were included in this study. The main demands received in the integrative community therapy circles were related to family conflicts, negative feelings, losses, health problems, and violence. About contributions, participating in the rounds provided users with autonomy, acceptance, empowerment, resilience, and self-care. Conclusion: Evidence pointed out that integrative community therapy was used as a strategy to care for mental health demands in several scenarios, highlighting it as a light technology, to be applied collectively in the community.

Objetivo: Investigar la producción científica sobre el uso de la terapia comunitaria integrativa para el cuidado de la salud mental. Métodos: Se trata de una revisión integrativa de la literatura científica realizada en noviembre de 2019 con las publicaciones de los últimos 13 años de las bases de datos a continuación: Base de Datos de Enfermería, Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online y Scientífic Eletronic Library Online. Resultados: Se ha encontrado 9.382 artículos y 17 han sido incluidos en el estudio. Las principales demandas recibidas en las ruedas de la terapia comunitaria integrativa se han relacionado con los conflictos familiares, los sentimientos negativos, las perdidas, los problemas de salud y la violencia. Respecto las contribuciones, la participación en las ruedas de conversación ha proporcionado la autonomía, la aceptación, el empoderamiento, la resiliencia y el autocuidado de los usuarios. Conclusión: Las evidencias señalaron que la terapia comunitaria integrativa ha sido utilizada como estrategia de cuidado de las demandas en salud mental de diversos escenarios evidenciándola como una tecnología leve para ser aplicada colectivamente en la comunidad.

Study protocol for the multicentre cohorts of Zika virus infection in pregnant women, infants, and acute clinical cases in Latin America and the Caribbean: the ZIKAlliance consortium.

BACKGROUND: The European Commission (EC) Horizon 2020 (H2020)-funded ZIKAlliance Consortium designed a multicentre study including pregnant women (PW), children (CH) and natural history (NH) cohorts. Clinical sites were selected over a wide geographic range within Latin America and the Caribbean, taking into account the dynamic course of the ZIKV epidemic. METHODS: Recruitment to the PW cohort will take place in antenatal care clinics. PW will be enrolled regardless of symptoms and followed over the course of pregnancy, approximately every 4 weeks. PW will be revisited at delivery (or after miscarriage/abortion) to assess birth outcomes, including microcephaly and other congenital abnormalities according to the evolving definition of congenital Zika syndrome (CZS). After birth, children will be followed for 2 years in the CH cohort. Follow-up visits are scheduled at ages 1-3, 4-6, 12, and 24 months to assess neurocognitive and developmental milestones. In addition, a NH cohort for the characterization of symptomatic rash/fever illness was designed, including follow-up to capture persisting health problems. Blood, urine, and other biological materials will be collected, and tested for ZIKV and other relevant arboviral diseases (dengue, chikungunya, yellow fever) using RT-PCR or serological methods. A virtual, decentralized biobank will be created. Reciprocal clinical monitoring has been established between partner sites. Substudies of ZIKV seroprevalence, transmission clustering, disabilities and health economics, viral kinetics, the potential role of antibody enhancement, and co-infections will be linked to the cohort studies. DISCUSSION: Results of these large cohort studies will provide better risk estimates for birth defects and other developmental abnormalities associated with ZIKV infection including possible co-factors for the variability of risk estimates between other countries and regions. Additional outcomes include incidence and transmission estimates of ZIKV during and after pregnancy, characterization of short and long-term clinical course following infection and viral kinetics of ZIKV. STUDY REGISTRATIONS: clinicaltrials.gov NCT03188731 (PW cohort), June 15, 2017; clinicaltrials.gov NCT03393286 (CH cohort), January 8, 2018; clinicaltrials.gov NCT03204409 (NH cohort), July 2, 2017.

Hierarchical drivers of soil microbial community structure variability in "Monte Perdido" Massif (Central Pyrenees).

Microbial activity is highly dependent on climatic factors (moisture and temperature) and edaphic characteristics in temperate ecosystems. Moreover, soil microbial community composition in high mountain areas is less known when compared to plant communities. In this study we investigated the soil microbial community from a functional perspective using PLFA (phospholipid fatty acid) methods in the four aspects of four summits (2,242 - 3,012 m above sea level) in the Spanish Central Pyrenees. Soil organic carbon (C), microbial biomass and nutrient dynamics ([Formula: see text] + [Formula: see text], N mineralization and nitrification potential) were also determined. Microbial biomass C was highest in the lowermost summit and decreased by approximately 50, 14 and 12% with increasing altitude. In each summit soil [Formula: see text] and [Formula: see text] concentrations differed significantly among summits and aspects. Soil nitrification potential varied significantly between the factors summit and aspects, e.g., southerly vs. northerly, easterly vs. westerly aspects. Gram negative bacteria and Actinobacteria functional groups dominated the microbial community, with almost 40% of the total PLFA. Non-metric multidimensional scale (NMS) analysis showed that most of the PLFA functional groups were present in all summits and aspects, although with specific biomarkers. A high abundance of biomarkers 16:1ω9c and 16:0 2OH (gram negative bacteria) were obtained in the lowermost summit, while the biomarkers 16.1ω7cDMA (anaerobes) and 19:3ω6c (Eukaryote) were only found in the uppermost summit. Linear mixed model (lmm) analysis was used with summit as fixed effect and aspect as random effect. In general, our results demonstrate a fundamental role for environment, principally moisture, temperature and organic matter in explaining the pattern observed for soil PLFA biomarkers. Under a global change scenario, we need to shed light on the relationships between soil microbial functional groups and soil nutrient-related variables in order to identify the associated patterns of decomposition rates and soil processes driven by microbial communities in mountain areas. The results could thus be used in global predictive models on climate change impact on C or N cycles in these environments.

Acesso a informações sobre substâncias psicoativas e o consumo por agentes prisionais / Acceso a la información sobre las sustancias psicoactivas y el consumo de éstas por los agentes penitenciários / Access to information about psychoactive substances and their consumption by penitentiary agents

Resumo O objetivo foi identificar o acesso às informações sobre substâncias psicoativas e o consumo destas por agentes prisionais. Trata-se de estudo exploratório e qualitativo. Foi realizado em umacadeia pública no estado de Mato Grosso, Brasil entre agosto e setembro de 2017, por meio de entrevista semiestruturada. Observou-se que os profissionais, em suamaioria, usam substâncias psicoativas, exclusivamente álcool e tabaco, combaixo consumo. Entre as mídiasmais utilizadas, prevaleceu a eletrônica. Verificou-se que, quanto maior tempo comalgumamídia, maior será a oportunidade de acesso a propagandas sobre substâncias psicoativas. Embora ese acesso não tenhare presentado aprendizados que auxiliem a adesão para estilos de vida mais saudáveis, sem o uso dessassubstâncias. A inclusão de atividades educativas nesseserviço permitirá que as informações sobre esas substâncias, bem como outros conteúdos importantes do cotidiano institucional ou veiculadosnas mídias impactem de forma positiva naqualidade de vida desse grupo.

Resumen El objetivo fue identificar el acceso a la información sobre sustancias psicoactivas y el consumo de éstas por agentes prisionales. Se trata de un estudio cualitativo exploratorio. Fue realizado en una cadena pública en el estado de Mato Grosso, Brasil entre agosto y septiembre de 2017, por medio de una entrevista semiestructurada.Se observó que los profesionales, en su mayoría, usan sustancias psicoactivas, exclusivamente alcohol y tabaco, con bajo consumo. Entre los medios más utilizados, prevaleció la electrónica. Se verificó que, cuanto mayor tiempo con algunos medios, mayor será la oportunidad de acceso a propagandas sobre sustancias psicoactivas. Aunque este acceso no ha representado aprendizajes que ayuden a la adhesión a estilos de vida más saludables, sin el uso de esas sustancias. Se concluye que la inclusión de actividades educativas en ese servicio permitirá que las informaciones sobre esas sustancias, así como otros contenidos importantes del cotidiano institucional o vehiculados en los medios impactan de forma positiva en la calidad de vida de ese grupo.

Abstract Theo bjective wasto identify the accessto information about psychoactive substances and their consumption by prison agents. Thisis a qualitative and exploratory study. It was carriedout in a publicjail in thes tateof Mato Grosso, Brazil between August and Septembervof 2017, through a semi-structured interview. It was observed that professionals, for the most part, use psychoactive substances, exclusively alcohol and tobacco, with low consumption. Among the mos tused media, electronics prevailed. It has been found that the more time with some media, the greater the opportunity of Access to advertisements on psychoactive substances. Although this Access did not represent learning that supports adherence to healthier lifestyles, without the use of these substances. The inclusión of educational activities in this service will allow the information about these substances, as well as other important contents of the institutional daily or transmitted in the media, to positively impact the quality of life of this group.

Clinical Indicators of Fatal Dengue in Two Endemic Areas of Colombia: A Hospital-Based Case-Control Study.

According to the World Health Organization, 98% of fatal dengue cases can be prevented; however, endemic countries such as Colombia have recorded higher case fatality rates during recent epidemics. We aimed to identify the predictors of mortality that allow risk stratification and timely intervention in patients with dengue. We conducted a hospital-based, case-control (1:2) study in two endemic areas of Colombia (2009-2015). Fatal cases were defined as having either 1) positive serological test (IgM or NS1), 2) positive virological test (RT-PCR or viral isolation), or 3) autopsy findings compatible with death from dengue. Controls (matched by state and year) were hospitalized nonfatal patients and had a positive serological or virological dengue test. Exposure data were extracted from medical records by trained staff. We used conditional logistic regression (adjusting for age, gender, disease's duration, and health-care provider) in the context of multiple imputation to estimate exposure to case-control associations. We evaluated 110 cases and 217 controls (mean age: 35.0 versus 18.9; disease's duration pre-admission: 4.9 versus 5.0 days). In multivariable analysis, retro-ocular pain (odds ratios [OR] = 0.23), nausea (OR = 0.29), and diarrhea (OR = 0.19) were less prevalent among fatal than nonfatal cases, whereas increased age (OR = 2.46 per 10 years), respiratory distress (OR = 16.3), impaired consciousness (OR = 15.9), jaundice (OR = 32.2), and increased heart rate (OR = 2.01 per 10 beats per minute) increased the likelihood of death (AUC: 0.97, 95% confidence interval: 0.96, 0.99). These results provide evidence that features of severe dengue are associated with higher mortality, which strengthens the recommendations related to triaging patients in dengue-endemic areas.

Burden of dengue among febrile patients at the time of chikungunya introduction in Piedecuesta, Colombia.

OBJECTIVE: To estimate the age-specific incidence of symptomatic dengue and chikungunya in Colombia. METHOD: A passive facility-based fever surveillance study was conducted among individuals with undifferentiated fever. Confirmatory diagnostics included serological and molecular tests in paired samples, and surveillance's underreporting was assessed using capture-recapture methods. RESULTS: Of 839 febrile participants 686 completed the study. There were 33.2% (295/839) dengue infections (51% primary infections), and 35.9% (191/532) of negative dengue cases there were chikungunya cases. On average, dengue cases were younger (median = 18 years) than chikungunya cases (median = 25 years). Thrombocytopaenia and abdominal pain were the main dengue predictors, while presence of rash was the main predictor for chikungunya diagnosis. Underreporting of dengue was 31%; the estimated expansion factors indicate an underreporting rate of dengue cases of threefold for all cases and of almost sixfold for inpatients. CONCLUSIONS: These findings highlight the ongoing coexistence of both arboviruses, a distinct clinical profile of each condition in the study area that could be used by clinicians to generate a differential diagnosis, and the presence of underreporting, mostly among hospitalised cases.

Serum fatty acids and progression from dengue fever to dengue haemorrhagic fever/dengue shock syndrome.

PUFA might modulate inflammatory responses involved in the development of severe dengue. We aimed to examine whether serum PUFA concentrations in patients diagnosed with dengue fever (DF) were related to the risk of progression to dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). A secondary aim was to assess correlations between fatty acids (FA) and inflammatory biomarkers in patients with DF. We conducted a prospective case-control study nested within a cohort of patients who were diagnosed with DF and followed during the acute episode. We compared the distribution of individual FA (% of total FA) at onset of fever between 109 cases who progressed to DHF/DSS and 235 DF non-progressing controls using unconditional logistic regression. We estimated correlations between baseline FA and cytokine concentrations and compared FA concentrations between the acute episode and >1 year post-convalescence in a subgroup. DHA was positively related to progression to DHF/DSS (multivariable adjusted OR (AOR) for DHA in quintile 5 v. 1=5·34, 95 % CI 2·03, 14·1; P trend=0·007). Dihomo-γ-linolenic acid (DGLA) was inversely associated with progression (AOR for quintile 5 v. 1=0·30, 95 % CI 0·13, 0·69; P trend=0·007). Pentadecanoic acid concentrations were inversely related to DHF/DSS. Correlations of PUFA with cytokines at baseline were low. PUFA were lower during the acute episode than in a disease-free period. In conclusion, serum DHA in patients with DF predicts higher odds of progression to DHF/DSS whereas DGLA and pentadecanoic acid predict lower odds.

Espiritualidad, autotrascendencia y consumo de alcohol en jóvenes universitarios / Spirituality, self-transcendence and alcohol consumption among university students / Espiritualidade, auto-transcendência e consumo de álcool em estudantes universitarios

alcohol en jóvenes universitarios. Método: estudio descriptivo correlacional, en 300 jóvenes, de dos Universidades del norte de México. Se aplicó una cedula de datos personales y prevalencia de consumo de alcohol, Escala de Autotrascendencia, Cuestionario de Espiritualidad, AUDIT. Resultados: 54.3% hombres, promedio de 19.6 años (DE±1.7), inicio de consumo de alcohol de 16.2 años (DE±1.71). Según la clasificación del AUDIT, no consumidores 37.3%, consumo sensato 25.0%, dependiente 20.3% y17.3% dañino. Se obtuvieron puntajes por encima del punto medio de espiritualidad (x=87.5 DE±12.0), autotrascendencia (x=47.6 DE±6.0), existe relación positiva significativa entre los dominios de espiritualidad entre si y auto trascendencia y espiritualidad (p=.000), el consumo de alcohol se relacionó negativa y significativamente con prácticas espirituales (p=.000), las prácticas religiosas tienen relación con el tipo consumo de alcohol (x2=11.96; p=.001). Conclusión: la práctica religiosa parece ser un factor de apoyo para el no consumo, las actividades incluidas en tal práctica son espacios para establecimiento de relaciones interpersonales más sanas, incluso de limitantes con normas, reglas que deben ser respetadas, ese vivir con posibilidades de integración y control parece proteger de alguna forma a los jóvenes.

Objective: to identify the relationship between spirituality, self-transcendence and alcohol consumption among university students. Method: descriptive correlational study, in 300 young people of two universities in northern Mexico. A personal data record and prevalence of alcohol consumption were applied, Self-Transcendence Scale, Spirituality Questionnaire and AUDIT. Results: 54.3% men, mean 19.6 years (SD±1.7), onset of alcohol consumption of 16.2 years (SD±1.71). According to the AUDIT classification, nonconsumers 37.3%, sensible consumption 25.0%, dependent 20.3% and 17.3% harmful. (x=87.5 SD±12.0), self - transcendence (x=47.6 ± 6.0), there is a significant positive relationship between the domains of spirituality among each other and self - transcendence and spirituality (p =. 000), alcohol consumption was negatively and significantly related to spiritual practices (p=.000), religious practices were related to the type of alcohol consumption (x2=11.96; p=.001). Conclusion: religious practice seems to be a support factor for non-consumption, the activities included in such practice are spaces for establishing healthier interpersonal relationships, including limitations with norms, rules that must be respected, that living with possibilities of integration And control seems to protect young people in some way.

Objetivo: identificar a relação entre espiritualidade, transcendência e consumo de álcool entre estudantes universitários. Método: estudo descritivo correlacional, com 300 jovens de duas universidades do norte do México. Utilizou-se um roteiro com dados pessoais e prevalência de álcool, Escala de Auto Transcendência, Questionário de Espiritualidade e AUDIT. Resultados: 54,3% do sexo masculino, média 19,6 anos (DE±1,7), a beber 16,2 anos (DE±1,71). Por FISCAL classificação, nonusers 37,3%, 25,0% consumo sensível, y17.3% dependente prejudicial 20,3%. pontuações foram obtidos acima do ponto médio da espiritual (X=87,5 DP±12,0), Autotranscendência (x=47,6 DP±6,0), havendo uma relação positiva significativa entre os domínios espirituais uns aos outros e auto importância e espiritual (p =. 000), o consumo de álcool de forma negativa e significativamente relacionada com as práticas espirituais (p=0,000), as práticas religiosas estão relacionados com o tipo de álcool (x2=11,96; p=0,001). Conclusão: a prática religiosa parece ser um fator de apoio para o não consumo. As atividades inclusas em tal prática constituem espaços para estabelecimento de relações interpessoais mais harmoniosas, com limites, normas e regras que devem ser respeitadas. Esse viver com posibilidades de integração e controle parece proteger de alguma forma os jovens.