The subjective perception of the happiness of older adult residents in Colombia.

Introduction: Happiness is understood as the perception of subjective well-being, it can be a quality, a result, or a state characterized by well-being or satisfaction that every person wants to achieve. In older adults, this satisfaction is a sum of lifelong achievements and triumphs; However, some factors influence this ideal. Objective: Analyze demographic, family, social, personal, and health factors associated with the subjective perception of happiness in older adults, using data from a study conducted in five cities in Colombia, in order to make a theoretical contribution in the search for improvement of their physical, mental and social health. Materials and methods: A quantitative, cross-sectional, analytical study was carried out, using primary source information, obtained with 2,506 surveys from voluntary participants aged 60 and over, who had no cognitive impairment, and who reside in urban areas but not in long-term centers. The variable happiness (classified as high or moderate/low) was used for: (1) A univariate explorative characterization of older adult, (2) a bivariate estimation of the relationships with the factors studied, and (3) a multivariate construction of profiles through multiple correspondences. Results: 67.2% reported high happiness levels, with differences by city: Bucaramanga (81.6%), Pereira (74.7%), Santa Marta (67.4), Medellín (64%), and Pereira (48.7%). Happiness was explained by the absence of risk of depression and little hopelessness, strengthened psychological well-being, a perception of high quality of life, and living in a functional family. Conclusion: This study provided an overview of possible factors that can be enhanced and strengthened with public policies (structural determinant), community empowerment, family strengthening (intermediate determinant), and educational programs (proximal determinant). These aspects are included in the essential functions of public health, in favor of mental and social health in older adults.

Sociodemographic, labor conditions, habits, lifestyles and diabetes mellitus in workers with subsistence jobs, Medellín-Colombia.

INTRODUCTION: According to American Diabetes Association, diabetes is a metabolic change characterized by the presence de hyperglycemia caused by a deficiency and/or malfunctioning of insulin secretion. OBJECTIVES: To determine sociodemographic and labor conditions, habits and lifestyles that explain diabetes in a group of informal street workers in downtown Medellín, Colombia. METHODS: This is a cross-sectional study with analytical intent based on primary sources information and on a survey with a sample of 686 workers in 2016, after obtaining informed consent. Study variables included sociodemographic and labor conditions, habits, lifestyles, and diagnosis of diabetes. Univariate, bivariate and multivariate analyses were performed. RESULTS: Workers with 50 years, 57.6% men, with a partner (56.8%), and more than 20 years in their profession. Higher prevalence of diabetes in those aged 18 to 44 and 45 to 59 years of age, lower schooling, consumed mid-morning, mid-afternoon, and evening snacks, and of households with food insecurity. Higher prevalence of diabetes was explained by: lower age, higher education, consumption of sugars, sweets, and desserts; and lower prevalence by consumption of mid-morning snacks, and household food insecurity. CONCLUSIONS: This disease of public health concern is explained by modifiable factors that can be controlled and avoided to improve the living and health conditions of this workers' population.

Educational inequalities in suicide in a middle-income country: A socioeconomic approach of mental health.

OBJECTIVE: This research aims to describe trends in inequalities in suicide mortality by educational level in Colombia between 1998 and 2015. METHOD: Standardized suicide mortality rates (SMR) were calculated by educational level, sex, and age in adult men and women over 25 years of age. Poisson regression models were used to calculate the RR (rate ratio) with those highly educated as a reference, and the RII (relative index of inequality). RESULTS: The number of reported deaths by suicide between 1998 and 2015 was 24,654, of which 84.7% were men. By age-group, 48.5% of suicides were among young adult men and women (25-44). Men had higher suicide rates than women (SMR men = 10.44/100,000; SMR women = 1.72/100,000). The age-standardized mortality rates (SMR) were higher in the groups with the lowest educational level in both sexes and all age-groups, except for senior adult women (65+). Broadly, while SMR reduced throughout most of the period, inequalities grew. CONCLUSIONS: We found that the educational inequities associated with suicide in Colombia grew slightly. This suggests the need to work on suicide prevention strategies that go beyond the individual risk factors. Socioeconomic issues need to be considered as a key tool to prevent suicide by improving peoples' quality of life and their mental health.

Vulneración a la integridad física de personas mayores: prevalencia del maltrato y factores asociados / Violation of the Physical Integrity of the Elderly: Prevalence of Abuse and Related Factors

Resumen El envejecimiento poblacional que experimenta actualmente América Latina trae consigo retos para la sociedad, como la prevención de la vulneración a los derechos humanos y libertades de las personas mayores y la eliminación de todas las formas de maltrato. La prevalencia de maltrato físico a personas mayores fue de 4,1%. Se presentó principalmente en mujeres, personas sin pareja y con ingreso económico. Además, fue más prevalente en personas mayores con riesgo de depresión, ante cedentes de pensamientos suicidas, insatisfacción con la salud y que convivían con familias disfuncionales. Los hallazgos de esta investigación muestran como las re laciones familiares pueden ser un factor clave a la hora de abordar la problemática del maltrato; además, las graves repercusiones que generan estos hechos sobre la víctima, como afectaciones no solo a la salud física sino también mental.

Abstract The ageing population currently experienced by Latin America brings with it cha llenges for society, such as the prevention of human rights violation and freedoms of the elderly, and the elimination of all forms of abuse. The prevalence of physical abuse for the elderly was 4.1%. It was mainly presented in women, people without a partner, and with financial income. In addition, it was more prevalent in older people at risk of depression, a history of suicidal thoughts, dissatisfaction with health, and living with dysfunctional families. The findings of this research show how family re lationships can be a key factor in addressing the problem of abuse. In addition, the serious impact of these facts on the victim, such as affectations not only to physical health, but also to mental health.

Hemorrhagic Cystitis after Haploidentical Transplantation with Post-Transplantation Cyclophosphamide: Protective Effect of MESNA Continuous Infusion.

Hemorrhagic cystitis (HC) is an important complication after haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide (PT-CY). Sodium 2-mercaptoethanesulfonate (MESNA) can prevent bladder injury when given with PT-CY. However, the best way to deliver MESNA is not known. This study assessed the incidence of HC after haplo-HSCT with PT-CY with 2 different methods of MESNA administration. The cumulative incidence of HC was lower in patients who received MESNA as a continuous infusion compared with those who received it as an intermittent bolus (5.6% versus 27.8%; P = .01). MESNA administration as an infusion was associated with a lower risk of developing HC (hazard ratio [HR], .19; 95% confidence interval [CI], .04 to .86; P = .02) on univariate analysis. This effect remained significant after adjustment in multivariate analysis (HR, .21; 95% CI, .04 to .88; P = .03). MESNA delivered as a continuous infusion is a simple and potentially useful way to prevent HC after PT-CY.

Index of vulnerability of elderly people in Medellín, Barranquilla, and Pasto

Introduction: Vulnerability can be defined as a lack of material and immaterial resources, which prevents the use of opportunities that may advance one's self-interest. The presence of these welfare resources prevents reductions in the quality of life. Objective: The objective of this study was to build an index of vulnerability using characteristics of the physical, human, social and functional capital of adults in three cities of Colombia in the year 2016 and to determine the factors that contribute most to vulnerability. Materials and methods: We conducted a transversal study with primary information sources applying 1,514 surveys among people aged 60 years and over in Medellín, Barranquilla, and Pasto. For the construction of the vulnerability index, we used factor analysis with varimax rotation and the principal component method. Results: The conditions that lead to a person's vulnerability were related mainly to human capital (quality of life, mental health and habits). The other types of capital that contributed to vulnerability were physical capital (occupation), social capital (accompaniment), and functional capital (functional independence). The highest vulnerability was registered among the residents of Pasto. The factors associated with vulnerability were the city of residence, the sex, the educational level and the role of the person in the home. Conclusion: In 58.55% of elderly people vulnerability was explained by the use of time, the functional independence and the subjective well-being. These findings contribute to the improvement of the quality of life, mainly those related to maintaining functional independence as long as possible, being occupied, improving mental health, and avoiding the risks of depression, anxiety, cognitive deterioration and deleterious habits.

Índice de vulnerabilidad de adultos mayores en Medellín, Barranquilla y Pasto / Index of vulnerability of elderly people in Medellín, Barranquilla, and Pasto

Resumen Introducción. La vulnerabilidad puede entenderse como la carencia de recursos materiales e inmateriales que impide el aprovechamiento de oportunidades en distintos aspectos de la vida. Estos recursos de bienestar evitan el deterioro de la calidad de vida. Objetivo. Construir un índice de vulnerabilidad con las características de los capitales físico, humano, social y funcional de los adultos mayores de tres ciudades de Colombia en el 2016, y determinar los factores asociados con esta condición. Materiales y métodos. Se hizo un estudio transversal con información primaria mediante 1.514 encuestas a personas de 60 años omásde Medellín, Barranquilla y Pasto. En la construcción del índice se usó el análisis factorial con losmétodos de componentes principales y de rotación ortogonal varimax. Resultados. Las condiciones que generaban vulnerabilidad se relacionaron principalmente con el capital humano (calidad de vida, salud mental y hábitos); los demás capitales aportaron un solo componente, así: capital físico (ocupación), capital social (acompañamiento) y capital funcional (independencia funcional). La vulnerabilidad fue mayor en los residentes de Pasto. Los factores asociados con la vulnerabilidad fueron la ciudad de residencia, el sexo, el nivel educativo y el rol en el hogar. Conclusión. En el 58,55 % de las personas mayores, la vulnerabilidad se explicó por el uso del tiempo, la independencia funcional y el bienestar subjetivo. Estos hallazgos aportan elementos para el mejoramiento de la calidad de vida, principalmente en cuanto a la capacidad funcional para mantener la independencia, estar ocupados y fortalecer la salud mental.

Abstract Introduction: Vulnerability can be defined as a lack of material and immaterial resources, which prevents the use of opportunities that may advance one's self-interest. The presence of these welfare resources prevents reductions in the quality of life. Objective: The objective of this study was to build an index of vulnerability using characteristics of the physical, human, social and functional capital of adults in three cities of Colombia in the year 2016 and to determine the factors that contribute most to vulnerability. Materials and methods: We conducted a transversal study with primary information sources applying 1,514 surveys among people aged 60 years and over in Medellín, Barranquilla, and Pasto. For the construction of the vulnerability index, we used factor analysis with varimax rotation and the principal component method. Results: The conditions that lead to a person's vulnerability were related mainly to human capital (quality of life, mental health and habits). The other types of capital that contributed to vulnerability were physical capital (occupation), social capital (accompaniment), and functional capital (functional independence). The highest vulnerability was registered among the residents of Pasto. The factors associated with vulnerability were the city of residence, the sex, the educational level and the role of the person in the home. Conclusion: In 58.55% of elderly people vulnerability was explained by the use of time, the functional independence and the subjective well-being. These findings contribute to the improvement of the quality of life, mainly those related to maintaining functional independence as long as possible, being occupied, improving mental health, and avoiding the risks of depression, anxiety, cognitive deterioration and deleterious habits.

[Trends in pertussis mortality and morbidity in Colombia, 2002-2012].

INTRODUCTION: Whooping cough is a public health problem that mainly affects children under one year of age with highly lethal outcomes. It is a re-emerging disease, which is preventable by immunization. Objective: To analyze mortality and morbidity trends of whooping cough in Colombia between 2002 and 2012. Materials and methods: We conducted a quantitative descriptive study of deaths by pertussis between 2002 and 2012 using data from death certificates registered by the Departamento Administrativo Nacional de Estadística, and cases reported to the Sistema Nacional de Vigilancia en Salud Pública, 2005-2012. Frequency measurements, morbidity and mortality ratios and female increased mortality were calculated. Results: Fifty one point two percent of the deaths occurred in women; the year with more deaths was 2012; 67.3% occurred in urban areas, and 43.5% of the subjects were affiliated to the subsidized health regime. The risk of illness was 1.88 per 1,000 live births with increased risk in Vaupés and Vichada. The risk of death was 0.02 per 1,000 live births; there was a decrease in the lethality trend. Conclusions: Pertussis has reemerged with increasing mortality and morbidity. Since this is a preventable disease through vaccination, it is advisable to increase control and enhance vaccination coverage in both children and adults, who are an important reservoir of the disease. The effective control of pertussis demands continued work aimed at early identification. It is also necessary to carry out actions to improve data quality in order to facilitate its analysis and the generation of more valid information.

[Evolution of the concept of positive mental health: a systematic review]. / Construcción del concepto de salud mental positiva: revisión sistemática.

Objective Characterize the theoretical models that have underpinned empirical research on the concept of positive mental health from the time it first emerged in the field of health up to the present. Methods A systematic search of the literature was conducted in PubMed, EBSCO (including Academic Search Complete, ERIC, Academic Source, MasterFILE Premier, MedicLatina, MEDLINE, and the Psychology and Behavioral Sciences Collection), Science Direct, Psicodoc, Springer Link, Taylor & Francis, Wiley Online Library, Directory of Open Access Journals (DOAJ), Redalyc, SciELO, Ovid, Embase, and ProQuest (including Health and Medical Complete, the Nursing and Allied Health Source, Psychology Journals, and Social Science Journals). The search criterion was the descriptor "positive mental health." Results Of 51 studies consulted, 84% used a quantitative approach; 84% were published in English; and the same percentage were conducted between 2000 and 2014. The concept of positive mental health has been applied in essentially five different ways: as the absence of disease; as the subject of the Jahoda model; as a combination of factors on the Lluch scale; as a synonym of well-being; and as part of more complex scales of measurement. Conclusions Positive mental health should not be viewed as the opposite of a mental disorder, the absence of disease, or the sum of a given set of personal conditions. It is important to move forward in the development of conceptual models that will serve as a basis for approaching mental health from the perspective of health promotion.

Tendencia de la mortalidad y la morbilidad por tos ferina en Colombia, 2002-2012 / Trends in pertussis mortality and morbidity in Colombia, 2002-2012

Introducción. La tos ferina es una enfermedad reemergente y, aunque es prevenible con la vacunación, constituye un problema de salud pública que afecta principalmente a niños menores de un año, en quienes se registra una gran letalidad. Objetivo. Analizar la tendencia de la mortalidad y la morbilidad por tos ferina en Colombia, entre 2002 y 2012. Materiales y métodos. Se hizo un estudio descriptivo cuantitativo de las muertes por tos ferina entre 2002 y 2012, con base en los datos de los certificados de defunción registrados por el Departamento Administrativo Nacional de Estadística, y los casos reportados al Sistema Nacional de Vigilancia en Salud Pública entre 2005 y 2012. Se calcularon medidas de frecuencia, tasas de morbilidad y mortalidad, y el aumento de la mortalidad femenina. Resultados. El 51,2 % de las muertes ocurrió en mujeres; el año con más defunciones fue el 2012; el 67,3 % ocurrió en el área urbana y el 43,5 % correspondía a personas afiliadas al régimen subsidiado de salud. El riesgo de enfermar fue de 1,88 por mil nacidos vivos, con mayor riesgo en los departamentos de Vaupés y Vichada. El riesgo de morir fue de 0,02 por mil nacidos vivos; la tendencia de la letalidad disminuyó en el periodo de estudio. Conclusión. Las tasas de mortalidad y morbilidad por tos ferina han vuelto a aumentar. Por ser esta una enfermedad prevenible mediante vacunación, se recomienda un mayor control y aumentar las coberturas de vacunación en niños y en adultos, quienes son un reservorio importante de la enfermedad. El control efectivo de la tos ferina requiere continuidad para su detección oportuna, así como acciones para mejorar la calidad de los datos, con el fin de facilitar el análisis y la producción de información válida.

Introduction: Whooping cough is a public health problem that mainly affects children under one year of age with highly lethal outcomes. It is a re-emerging disease, which is preventable by immunization. Objective: To analyze mortality and morbidity trends of whooping cough in Colombia between 2002 and 2012. Materials and methods: We conducted a quantitative descriptive study of deaths by pertussis between 2002 and 2012 using data from death certificates registered by the Departamento Administrativo Nacional de Estadística , and cases reported to the Sistema Nacional de Vigilancia en Salud Pública , 2005-2012. Frequency measurements, morbidity and mortality ratios and female increased mortality were calculated. Results: Fifty one point two percent of the deaths occurred in women; the year with more deaths was 2012; 67.3% occurred in urban areas, and 43.5% of the subjects were affiliated to the subsidized health regime. The risk of illness was 1.88 per 1,000 live births with increased risk in Vaupés and Vichada. The risk of death was 0.02 per 1,000 live births; there was a decrease in the lethality trend. Conclusions: Pertussis has reemerged with increasing mortality and morbidity. Since this is a preventable disease through vaccination, it is advisable to increase control and enhance vaccination coverage in both children and adults, who are an important reservoir of the disease. The effective control of pertussis demands continued work aimed at early identification. It is also necessary to carry out actions to improve data quality in order to facilitate its analysis and the generation of more valid information.

Construcción del concepto de salud mental positiva: revisión sistemática / Evolution of the concept of positive mental health: a systematic review

Objetivo. Caracterizar los modelos teóricos que han fundamentado las investigaciones empíricas sobre salud mental positiva desde el momento en que aparece el concepto en el campo de la salud hasta la actualidad. Métodos. Se realizó un proceso sistemático de búsqueda de literatura, publicada en las bases de datos PubMed, Ebsco (Academic Search Complete, ERIC, Fuente Académica, MasterFILE premier, MedicLatina, Medline y Psychology and Behavioral Sciences Collection), Science Direct, Psicodoc, Springer Link, Taylor and Francys, Wiley Online Library, DOAJ (Directory of Open Access Journals), Redalyc, Scielo, Ovid, Embase y Proquest (Psychology Journals, Nursing and Allied Health Source, Health and Medical Complete y Social Science Journals). Se utilizó como criterio de búsqueda el descriptor “salud mental positiva”. Resultados. De los 51 estudios consultados, 84% presentan un enfoque cuantitativo y también 84% están publicados en inglés y fueron realizados entre los años 2000 y 2014. Se identificaron cinco categorías en la utilización del concepto salud mental positiva: la ausencia de enfermedad como indicador de salud mental positiva, el modelo de Jahoda, el desarrollo de la escala de Lluch, la utilización del concepto de bienestar como sinónimo de salud mental positiva y un reciente interés por diseñar escalas de medición. Conclusiones. La salud mental positiva no debe ser entendida como la antinomia del trastorno mental, la ausencia de enfermedad o la simple suma de atributos personales. Es importante avanzar en el desarrollo de modelos conceptuales que servirán como fundamento para el abordaje de la salud mental desde un enfoque centrado en la promoción de la salud.

Objective. Characterize the theoretical models that have underpinned empirical research on the concept of positive mental health from the time it first emerged in the field of health up to the present. Methods. A systematic search of the literature was conducted in PubMed, EBSCO (including Academic Search Complete, ERIC, Academic Source, MasterFILE Premier, MedicLatina, MEDLINE, and the Psychology and Behavioral Sciences Collection), Science Direct, Psicodoc, Springer Link, Taylor & Francis, Wiley Online Library, Directory of Open Access Journals (DOAJ), Redalyc, SciELO, Ovid, Embase, and ProQuest (including Health and Medical Complete, the Nursing and Allied Health Source, Psychology Journals, and Social Science Journals). The search criterion was the descriptor “positive mental health.” Results. Of 51 studies consulted, 84% used a quantitative approach; 84% were published in English; and the same percentage were conducted between 2000 and 2014. The concept of positive mental health has been applied in essentially five different ways: as the absence of disease; as the subject of the Jahoda model; as a combination of factors on the Lluch scale; as a synonym of well-being; and as part of more complex scales of measurement. Conclusions. Positive mental health should not be viewed as the opposite of a mental disorder, the absence of disease, or the sum of a given set of personal conditions. It is important to move forward in the development of conceptual models that will serve as a basis for approaching mental health from the perspective of health promotion.

Construcción del concepto de salud mental positiva: revisión sistemática / Evolution of the concept of positive mental health: a systematic review

RESUMEN Objetivo Caracterizar los modelos teóricos que han fundamentado las investigaciones empíricas sobre salud mental positiva desde el momento en que aparece el concepto en el campo de la salud hasta la actualidad. Métodos Se realizó un proceso sistemático de búsqueda de literatura, publicada en las bases de datos PubMed, Ebsco (Academic Search Complete, ERIC, Fuente Académica, MasterFILE premier, MedicLatina, Medline y Psychology and Behavioral Sciences Collection), Science Direct, Psicodoc, Springer Link, Taylor and Francys, Wiley Online Library, DOAJ (Directory of Open Access Journals), Redalyc, Scielo, Ovid, Embase y Proquest (Psychology Journals, Nursing and Allied Health Source, Health and Medical Complete y Social Science Journals). Se utilizó como criterio de búsqueda el descriptor “salud mental positiva”. Resultados De los 51 estudios consultados, 84% presentan un enfoque cuantitativo y también 84% están publicados en inglés y fueron realizados entre los años 2000 y 2014. Se identificaron cinco categorías en la utilización del concepto salud mental positiva: la ausencia de enfermedad como indicador de salud mental positiva, el modelo de Jahoda, el desarrollo de la escala de Lluch, la utilización del concepto de bienestar como sinónimo de salud mental positiva y un reciente interés por diseñar escalas de medición. Conclusiones La salud mental positiva no debe ser entendida como la antinomia del trastorno mental, la ausencia de enfermedad o la simple suma de atributos personales. Es importante avanzar en el desarrollo de modelos conceptuales que servirán como fundamento para el abordaje de la salud mental desde un enfoque centrado en la promoción de la salud.

ABSTRACT Objective Characterize the theoretical models that have underpinned empirical research on the concept of positive mental health from the time it first emerged in the field of health up to the present. Methods A systematic search of the literature was conducted in PubMed, EBSCO (including Academic Search Complete, ERIC, Academic Source, MasterFILE Premier, MedicLatina, MEDLINE, and the Psychology and Behavioral Sciences Collection), Science Direct, Psicodoc, Springer Link, Taylor & Francis, Wiley Online Library, Directory of Open Access Journals (DOAJ), Redalyc, SciELO, Ovid, Embase, and ProQuest (including Health and Medical Complete, the Nursing and Allied Health Source, Psychology Journals, and Social Science Journals). The search criterion was the descriptor “positive mental health.” Results Of 51 studies consulted, 84% used a quantitative approach; 84% were published in English; and the same percentage were conducted between 2000 and 2014. The concept of positive mental health has been applied in essentially five different ways: as the absence of disease; as the subject of the Jahoda model; as a combination of factors on the Lluch scale; as a synonym of well-being; and as part of more complex scales of measurement. Conclusions Positive mental health should not be viewed as the opposite of a mental disorder, the absence of disease, or the sum of a given set of personal conditions. It is important to move forward in the development of conceptual models that will serve as a basis for approaching mental health from the perspective of health promotion.

[Level of and change in road traffic mortality in Argentina, Chile, Colombia and Mexico, 2000-2011]. / Nivel y cambio de la mortalidad vial en Argentina, Chile, Colombia y México, 2000-2011.

The aim of this study was to estimate the effect of run-over fatalities and traffic collisions in life expectancy in Argentina, Chile, Colombia and Mexico, between 2000 and 2011. Years of life expectancy lost (YLEL) were calculated for the periods 2000-2002 and 2009-2011. The results show that road traffic deaths made up between 1% and 4% of all deaths in each country. In the first period, the highest level of mortality occurred in Colombia (YLEL=0.96) and the lowest in Argentina (YLEL=0.59). In all the countries studied except Argentina, the impact of these deaths on life expectancy was reduced in the second period. The main change took place in Colombia, reaching 0.72 YLEL in the second period. It is concluded that traffic-related deaths have a negative impact on health systems, victims, the productive sector, and society in general. From this point of view, the issue of road transit must be considered a matter of public health, requiring multi-sector intervention in the design of national and regional policies.

Nivel y cambio de la mortalidad vial en Argentina, Chile, Colombia y México, 2000-2011 / Level of and change in road traffic mortality in Argentina, Chile, Colombia and Mexico, 2000-2011

El objetivo de este trabajo es estimar el efecto de las muertes por atropellos y colisiones de tránsito en la esperanza de vida en Argentina, Chile, Colombia y México, entre 2000 y 2011. Se calcularon los años de esperanza de vida perdidos (AEVP) para los trienios 2000-2002 y 2009-2011. Los resultados indican que los decesos ocurridos por el tránsito representaron entre el 1% y el 4% del total para cada país. En el primer trienio, el mayor nivel de mortalidad ocurrió en Colombia (AEVP=0,96), mientras que el más bajo se registró en Argentina (AEVP=0,59). A excepción de este último país, hacia el segundo trienio, se redujo el impacto de estos fallecimientos sobre la esperanza de vida. El principal cambio tuvo lugar en Colombia que pasó a 0,72 AEVP. Se concluye que las muertes asociadas con el tránsito impactan de manera negativa en los sistemas de salud, las víctimas, el sector productivo y la sociedad en general. Desde esta perspectiva, la situación vial representa un problema de salud pública que requiere la intervención multisectorial en el diseño de políticas de alcance nacional y regional.

The aim of this study was to estimate the effect of run-over fatalities and traffic collisions in life expectancy in Argentina, Chile, Colombia and Mexico, between 2000 and 2011. Years of life expectancy lost (YLEL) were calculated for the periods 2000-2002 and 2009-2011. The results show that road traffic deaths made up between 1% and 4% of all deaths in each country. In the first period, the highest level of mortality occurred in Colombia (YLEL=0.96) and the lowest in Argentina (YLEL=0.59). In all the countries studied except Argentina, the impact of these deaths on life expectancy was reduced in the second period. The main change took place in Colombia, reaching 0.72 YLEL in the second period. It is concluded that traffic-related deaths have a negative impact on health systems, victims, the productive sector, and society in general. From this point of view, the issue of road transit must be considered a matter of public health, requiring multi-sector intervention in the design of national and regional policies.

Nivel y cambio de la mortalidad vial en Argentina, Chile, Colombia y México, 2000-2011 / Level of and change in road traffic mortality in Argentina, Chile, Colombia and Mexico, 2000-2011

El objetivo de este trabajo es estimar el efecto de las muertes por atropellos y colisiones de tránsito en la esperanza de vida en Argentina, Chile, Colombia y México, entre 2000 y 2011. Se calcularon los años de esperanza de vida perdidos (AEVP) para los trienios 2000-2002 y 2009-2011. Los resultados indican que los decesos ocurridos por el tránsito representaron entre el 1% y el 4% del total para cada país. En el primer trienio, el mayor nivel de mortalidad ocurrió en Colombia (AEVP=0,96), mientras que el más bajo se registró en Argentina (AEVP=0,59). A excepción de este último país, hacia el segundo trienio, se redujo el impacto de estos fallecimientos sobre la esperanza de vida. El principal cambio tuvo lugar en Colombia que pasó a 0,72 AEVP. Se concluye que las muertes asociadas con el tránsito impactan de manera negativa en los sistemas de salud, las víctimas, el sector productivo y la sociedad en general. Desde esta perspectiva, la situación vial representa un problema de salud pública que requiere la intervención multisectorial en el diseño de políticas de alcance nacional y regional.(AU)

The aim of this study was to estimate the effect of run-over fatalities and traffic collisions in life expectancy in Argentina, Chile, Colombia and Mexico, between 2000 and 2011. Years of life expectancy lost (YLEL) were calculated for the periods 2000-2002 and 2009-2011. The results show that road traffic deaths made up between 1% and 4% of all deaths in each country. In the first period, the highest level of mortality occurred in Colombia (YLEL=0.96) and the lowest in Argentina (YLEL=0.59). In all the countries studied except Argentina, the impact of these deaths on life expectancy was reduced in the second period. The main change took place in Colombia, reaching 0.72 YLEL in the second period. It is concluded that traffic-related deaths have a negative impact on health systems, victims, the productive sector, and society in general. From this point of view, the issue of road transit must be considered a matter of public health, requiring multi-sector intervention in the design of national and regional policies.(AU)

[Contextual effects associated with depression risk variability in the elderly, Antioquia, Colombia, 2012]. / Efectos contextuales asociados a la variabilidad del riesgo de depresión en adultos mayores, Antioquia, Colombia, 2012.

INTRODUCTION: Depression is an affective disorder where interest in living is lost and functional areas like work, feelings, personal life, and relationships are negatively altered. However, little has been said about the association between place of residence and this mood disorder. OBJECTIVE: To determine the effects of the municipality and block of residence on the depression risk variability in the elderly in the Department of Antioquia, Colombia, in 2012. MATERIALS AND METHODS: This was a multilevel descriptive study of secondary source records of 4,060 elderly people from the Department of Antioquia. Demographic, social and functional characteristics were assessed to calculate raw and adjusted odds ratios and find an association between the risk of depression, as measured by Yesavage´s Geriatric Depression Scale, and context variables (municipality and block of residence) in the design of the model. We used Markov chain Monte Carlo estimation methods and the deviance information criterion to assess goodness of fit. RESULTS: The prevalence of the risk of depression was 29.5% and we found an association with ages over 75 years, being female, residing in rural areas, and widowhood. Additionally, they had a higher risk of anxiety, moderate functional capacity and malnutrition. The municipality and block of residence were associated with this risk in the elderly. CONCLUSIONS: The municipality and block of residence had a 10% contribution toward the total variability in the risk of depression for the elderly. This information is important to encourage participation and adherence of the elderly to community groups.

The public health impact of economic fluctuations in a Latin American country: mortality and the business cycle in Colombia in the period 1980-2010.

INTRODUCTION: Studies in high-income countries suggest that mortality is related to economic cycles, but few studies have examined how fluctuations in the economy influence mortality in low- and middle-income countries. We exploit regional variations in gross domestic product per capita (GDPpc) over the period 1980-2010 in Colombia to examine how changes in economic output relate to adult mortality. METHODS: Data on the number of annual deaths at ages 20 years and older (n = 3,506,600) from mortality registries, disaggregated by age groups, sex and region, were linked to population counts for the period 1980-2010. We used region fixed effect models to examine whether changes in regional GDPpc were associated with changes in mortality. We carried out separate analyses for the periods 1980-1995 and 2000-2010 as well as by sex, distinguishing three age groups: 20-44 (predominantly young working adults), 45-64 (middle aged working adults), and 65+ (senior, predominantly retired individuals). RESULTS: The association between regional economic conditions and mortality varied by period and age groups. From 1980 to 1995, increases in GDPpc were unrelated to mortality at ages 20 to 64, but they were associated with reductions in mortality for senior men. In contrast, from 2000 to 2010, changes in GDPpc were not associated with old age mortality, while an increase in GDPpc was associated with a decline in mortality at ages 20-44 years. Analyses restricted to regions with high registration coverage yielded similar albeit less precise estimates for most sub-groups. CONCLUSIONS: The relationship between business cycles and mortality varied by period and age in Colombia. Most notably, mortality shifted from being acyclical to being countercyclical for males aged 20-44, while it shifted from being countercyclical to being acyclical for males aged 65+.

Factores asociados al maltrato del adulto mayor de Antioquia, 2012 / Associated factors of the abuse of the elderly people in Antioquia, 2012

OBJETIVO: determinar los factores asociados al maltrato del adulto mayor del departamento de Antioquia en el año 2012. METODOLOGIA:mediante estudio descriptivo transversal, se caracterizaron los factores demográficos, económicos y de salud mental de la población adulta mayor de Antioquia para el año 2012, con el fin de aportar al análisis de la situación de salud y condiciones de vida del adulto mayor. El estudio se basó en los resultados del instrumento aplicado por la universidad CES a 4.215 adultos de sesenta años y más de edad, en el cual se indagó sobre percepción de maltrato, funcionamiento cognitivo, nivel de depresión, nivel de ansiedad, apoyo social, escala de recursos sociales, entre otras; los resultados se expandieron a 654.473 adultos del departamento. RESULTADOS: el 72,8% de adultos del departamento son mujeres, 53,7% vive en Medellín, 55% tiene primaria incompleta, 72,9% pertenece a estratos socioeconómicos 1 y 2, 45,1% no registraron ingresos en el último mes, 26,3% tiene riesgo de depresión y 34,4% tiene riesgo de ansiedad, 2,5% reportó haber sufrido descuido, 5,0% necesidades afectivas ignoradas, 1,7% algún caso de agresión física, 0,4% agresión sexual y 1,3%, afirmó haber sufrido maltrato económico. Las variables estrato socioeconómico, tipo de vivienda, etnia, riesgo de depresión, riesgo de ansiedad, riesgo de deterioro cognitivo y red de apoyo fueron las que más ayudaron a explicar la presencia de maltrato. CONCLUSION: enfrentar este problema requiere de una atención integral a las necesidades de los adultos mayores, participación de todos los sectores de la sociedad y conciencia transgeneracional.

OBJECTIVE:to determine the demographic, social and economic factors associated with the abuse of elderly people in 2012. METHODOLOGY: using a descriptive and retrospective study, demographic, economic and mental health factors of the elderly population of Antioquia for 2012 were charaterized in order to contribute to the analysis of their health situation and living conditions. The study was based on the results of the instrument applied by the CES university to 4,215 adults aged 60 and older in which I inquire about perceived abuse, cognitive functioning, level of depression, anxiety level, social support scale, social resources, etc. Results expanded to 654,473 adults in the Department. RESULTS :72.8% of adults in the Department are women, 53.7% live in Medellin, 55% have not completed elementary school, 72.9% belonged to 1 and 2 socioeconomic strata, 45.1% reported no income in the last month, 26.3% are at risk of depression and 34.4% are at risk of anxiety, 2.5% reported having suffered neglect, 5.0% reported having emotional needs that are ignored, 1.7% suffered some form of physical assault, 0.4% had been assaulted sexually and 1.3% claimed to have suffered financial abuse. The socioeconomic variables housing type, ethnicity, risk of depression, anxiety, risk, risk of cognitive decline and support network were the most helpful in explaining the presence of abuse. CONCLUSION: addressing this problem requires comprehensive attention to the needs of older adults involving all sectors of society and transgenerational consciousness.

Efectos contextuales asociados a la variabilidad del riesgo de depresión en adultos mayores, Antioquia, Colombia, 2012 / Contextual effects associated with depression risk variability in the elderly, Antioquia, Colombia, 2012

Introducción. La depresión es un trastorno del afecto en el que se pierde el interés de vivir y se alteran de manera negativa los ámbitos laboral, afectivo, relacional y personal. Sin embargo, poco se sabe sobre si hay asociación entre el lugar de residencia y dicha alteración del estado de ánimo. Objetivo. Determinar los efectos del municipio y la manzana de residencia en la variabilidad del riesgo de depresión en los adultos mayores del departamento de Antioquia, Colombia, en el 2012. Materiales y métodos. Se llevó a cabo un estudio descriptivo multinivel de fuente secundaria con 4.060 registros de adultos mayores del departamento de Antioquia. Se valoraron características demográficas, sociales y funcionales en el cálculo de las razones de momios ( odds ratio, OR) crudas y ajustadas, para buscar asociación entre el riesgo de depresión medida con la escala de depresión geriátrica de Yesavage y las variables de contexto (municipio y manzana de residencia) en la construcción del modelo, utilizando los métodos de cadenas de Markov Monte Carlo ( Markov Chain Monte Carlo , MCMC); la bondad de ajuste de los modelos se evaluó mediante el criterio de información de la desviación ( Deviance Information Criterion , DIC). Resultados. La prevalencia del riesgo de depresión fue de 29,5 % y se encontró asociación con la edad mayor de 75 años, el sexo femenino, la residencia en zona rural y la condición de viudez. De igual forma, se encontró riesgo de experimentar ansiedad, capacidad funcional moderada y alto riesgo de desnutrición. Se encontró asociación entre el municipio y la manzana de residencia, y el riesgo de depresión. Conclusiones. El municipio y la manzana de residencia aportaron 10 % de la variabilidad total del riesgo de depresión en los adultos mayores. Esta información es importante para fomentar la participación y adhesión de los adultos mayores a grupos comunitarios.

Introduction: Depression is an affective disorder where interest in living is lost and functional areas like work, feelings, personal life, and relationships are negatively altered. However, little has been said about the association between place of residence and this mood disorder. Objective: To determine the effects of the municipality and block of residence on the depression risk variability in the elderly in the Department of Antioquia, Colombia, in 2012. Materials and methods: This was a multilevel descriptive study of secondary source records of 4,060 elderly people from the Department of Antioquia. Demographic, social and functional characteristics were assessed to calculate raw and adjusted odds ratios and find an association between the risk of depression, as measured by Yesavage´s Geriatric Depression Scale, and context variables (municipality and block of residence) in the design of the model. We used Markov chain Monte Carlo estimation methods and the deviance information criterion to assess goodness of fit. Results: The prevalence of the risk of depression was 29.5% and we found an association with ages over 75 years, being female, residing in rural areas, and widowhood. Additionally, they had a higher risk of anxiety, moderate functional capacity and malnutrition. The municipality and block of residence were associated with this risk in the elderly. Conclusions: The municipality and block of residence had a 10% contribution toward the total variability in the risk of depression for the elderly. This information is important to encourage participation and adherence of the elderly to community groups.