Modelo sinérgico de salud: una integración de la salutogénesis y el modelo de activos para la salud.

Se propone un "modelo sinérgico" para avanzar en la integración de elementos clave de la salutogénesis y el modelo de activos para la salud, utilizando como marco para esta articulación la teoría bioecológica de Bronfenbrenner. El sentido de coherencia es clave para facilitar la transformación de recursos potenciales en activos disponibles, produciendo un desarrollo positivo de la salud. El modelo sinérgico puede aportar a la contextualización de las ideas en políticas y prácticas de salud pública, fortaleciendo la dimensión salud-bienestar y contribuyendo al desarrollo de modelos de salud más integrados y colectivos.

Promoción de salud más allá de los estilos de vida saludables: propuestas de actuación en una universidad chilena.

Las intervenciones centradas en cambios de conducta, sumadas a la escasa evidencia de mapeo y dinamización de activos en Universidades Promotoras de Salud (UPS), hacen necesario potenciar enfoques integrales y sistémicos que contribuyan al bienestar y empoderamiento de sus integrantes. El objetivo de este artículo es explorar propuestas de acción que contribuyan a fortalecer activos en una comunidad universitaria chilena. Se desarrolló un estudio cualitativo con 72 hombres/77 mujeres (estudiantes, trabajadores, jubilados y exestudiantes). Se realizaron 48 entrevistas individuales y 14 grupos focales. Se efectuó un análisis de contenido utilizando el software QRS NVivo 12. Las propuestas identificadas se agruparon en: desarrollo de la participación e inclusión, promoción de la salud mental, mantenimiento y mejora de áreas verdes e infraestructura, y fortalecimiento del acceso a actividades deportivas, culturales y de extensión universitaria. Las mujeres valoraron la difusión de activos comunitarios y el cuidado de las personas y el entorno. Y los hombres, el fortalecimiento del capital social, la docencia y la transferencia de conocimiento. Las propuestas de acción tienen una orientación colectiva que favorece el vínculo de las personas con su entorno y el desarrollo del sentido de comunidad. Desde una perspectiva de género, se observa reproducción de roles y estereotipos arraigados en el sistema patriarcal. Esto constituye un desafío para potenciar las UPS en tanto política pública, considerando los principios de participación, justicia social y equidad.

Automanejo en personas con multimorbilidad: aportes desde la salutogénesis y el modelo de activos en salud / Self-management in people with multimorbility: Contributions from salutogenesis and health assets model

Diferentes modelos de cuidado en contexto de cronicidad y multimorbilidad incorporan a la comunidad, sistema de salud, práctica clínica, políticas sanitarias, prevención y promoción de salud. Entre estos se señala el rol facilitador del equipo de salud en el automanejo, siendo las personas protagonistas de su proceso. El abordaje de la multimorbilidad se realiza mayormente desde un enfoque centrado en el riesgo y la enfermedad, limitando la exploración de los recursos de las personas y su entorno. Incorporar un enfoque de salud positiva puede aportar a una mayor integralidad. El propósito de este artículo es proponer un abordaje desde el modelo sinérgico de salud, integrando la salutogénesis y el modelo de activos, para facilitar el automanejo promoviendo la capacidad de agencia de las personas. Se presentan potenciales áreas de aplicación de estos modelos en el contexto de multimorbilidad, fomentando condiciones de salud y bienestar en las personas y sus familias.(AU)

Different models of care in context of chronicity and multimorbidity include community, health system, clinical practice, health policies, prevention, and health promotion. Among these, the role of the health team as a facilitator of self-management is pointed out, being people the protagonists of their process. Multimorbidity approach is mostly carried out from a risk and disease focused point of view, which limits the exploration of resources of people and their environment. Incorporating a positive health approach can contribute to a greater comprehensiveness. The purpose of this article is to propose an approach from the synergy model of health, integrating salutogenesis and health assets model, to help facilitate self-management promoting people's agency capacity. Potential areas of application of these models are presented to work in the context of multimorbidity, promoting health and well-being conditions in people and their families.(AU)

[Self-management in people with multimorbility: Contributions from salutogenesis and health assets model]. / Automanejo en personas con multimorbilidad: aportes desde la salutogénesis y el modelo de activos en salud.

Different models of care in context of chronicity and multimorbidity include community, health system, clinical practice, health policies, prevention, and health promotion. Among these, the role of the health team as a facilitator of self-management is pointed out, being people the protagonists of their process. Multimorbidity approach is mostly carried out from a risk and disease focused point of view, which limits the exploration of resources of people and their environment. Incorporating a positive health approach can contribute to a greater comprehensiveness. The purpose of this article is to propose an approach from the synergy model of health, integrating salutogenesis and health assets model, to help facilitate self-management promoting people's agency capacity. Potential areas of application of these models are presented to work in the context of multimorbidity, promoting health and well-being conditions in people and their families.

Verrugas plantares recalcitrantes tratadas exitosamente con sólo una sesión de Láser PDL. A propósito de 3 casos / Recalcitrant plantar warts successfully treated with one PDL session. About 3 cases

Resumen Las verrugas plantares son una patología común en la población. Estas lesiones son a menudo dolorosas y recidivantes. Entre los tratamientos más utilizados están las terapias tópicas destructivas y menos frecuentemente el tratamiento quirúrgico. Sin embargo, con frecuencia recurren, por lo que representan un desafío para el dermatólogo. Presentamos 3 casos de pacientes varones adultos con verrugas plantares recalcitrantes que fueron tratadas exitosamente con una sola sesión de láser PDL, sin recidiva luego de 8 a 12 meses de seguimiento.

Abstract Plantar warts are a common pathology in the population. These lesions are often painful and recurring. Among the most used treatments are topical destructive therapies, and less frequently, surgical treatment. However, they frequently recur, so they represent a challenge for the dermatologist. We present 3 adult males with a recalcitrant plantar wart that were successfully treated with a single PDL laser session, without relapse after 8-12 months of follow-up.

Asset map in a Chilean Health Promoting University: 'a strategy for revitalization'.

Health Promoting Universities (HPUs) are more likely to perform actions intended to change habits and increase personal empowerment, than they are to develop community actions. The objective of this research is to create an asset map to visualize collective actions in a Chilean HPU. A qualitative study, based on the ABCD model was conducted. There were 149 people, distributed into 48 semi-structured interviews and 14 focus groups, who participated in this study (students, employees, ex-students and retirees). An asset map was elaborated, identifying the contributions of residents, associations and organizations, local institutions, physical resources, economic assets and local culture and with a new category, 'connecting assets'. These categories show the range of resources in a university. According to the participants, the questions on asset identification were a tool for reflection, and by giving their opinions and discovering or drawing attention to new resources, they gained a better understanding of the assets in the university. Several participants stated that these talks could generate a positive emotional environment, which boosted their wellbeing. There were gender- and group-based differences in how the assets were valued. Students stressed assets related to services and benefits from the institution, green areas, and collective spaces. Employees, retirees and ex-students emphasized assets related to belonging, identity and traditions. Men appreciated openness and privacy in physical spaces. Women highlighted assets related to the institution. The resulting map, displays a range of resources that can help the university develop new possibilities for comprehensive and collective actions that would revitalize the HPU strategy.

The need for adolescents' agency in salutogenic approaches shaping physical activity in schools.

Physical activity (PA) contributes to health throughout life. In particular, young people can benefit from this. Schools can play a key role in providing learning conditions to experience meaningful PAs aimed at inspiring students to lifelong PA. In this article, we argue the need for a salutogenic approach in schools focussing on respecting and enhancing adolescents' agency with regard to their PA. This approach entails listening to adolescents' perspectives and inviting them to participate in actively designing and carrying out PA as a prerequisite for their inclusive engagement. We unpack the concept of agency by drawing on insights from the Capability Approach. This provides input for the integration of agency in health promoting schools and salutogenic approaches, to enhance PA-related agency. Finally, we outline a research agenda to, eventually, create opportunities for students in schools to expand their PA-related agency. Lay Summary Physical activity (PA) contributes to health throughout life. Schools can play a key role in fostering meaningful PA experiences to inspire students to lifelong PA. This requires schools to focus on students' personal aspirations, providing them with the space to develop their autonomy and find opportunities to decide and act upon expanding their agency with respect to the physically active lifestyles they deem meaningful.

'A synergy model of health': an integration of salutogenesis and the health assets model.

This article proposes to advance the connections between salutogenic theory and assets models for health improvement. There is a need to integrate their use in public health and health promotion so that their respective potentials can be fully developed. This requires their synergies to be made more explicit so that a more coherent approach can be taken to their utilization. A mechanism is therefore needed that helps to raise awareness of them and their value as a resource together. Bronfenbrenner's bioecological theory provides one framework that can support better integration of salutogenesis with the applied nature of assets-based models. This paper proposes a new 'synergy model for health' that integrates key concepts associated with salutogenic theory-generalized and specific resistance resources (GRRs/SRRs) and generalized and specific resistance deficits and the sense of coherence (SOC). In doing so, it highlights those GRRs and SRRs which are assets that, either individually or collectively, help to develop a stronger SOC. Higher levels of SOC can then support the transformations of potential resources into available assets (that people can understand, manage and make sense of), capable of producing positive health development. The proposed 'Synergy model of health' aims to contribute to a deeper theoretical understanding of health and development through the integration of the key elements of both salutogenesis and assets models. This can facilitate a better contextualization of the ideas into public health policy and practice by making the salutogenic theory more action-oriented and the assets model more theoretical.

Populosis bowenoide en pene. Dos casos con buena respuesta a crioterapia / Bowenoid populosis in penis. Two cases with good response to cryotherapy

La papulosis bowenoide es un carcinoma espinocelular in situ de bajo grado que se observa mayormente en genitales. El agente etiológico es el virus del papiloma humano. Existen múltiples opciones terapéuticas médicas y quirúrgicas pero debería ser tratado de forma conservadora. Presentamos dos casos de papulosis bowenoide tratados exitosamente con crioterapia (AU)

Bowenoid papulosis is a low grade squamous cell in situ carcinoma. It is usually seen in genitals. Etiologic agent is the human papilloma virus. There are many treatments available but it should be treated conservatively. Two cases of bowenoid papulosis with good response to cryotherapy are reported (AU)

Mobile teleradiology system suitable for m-health services supporting content and semantic based image retrieval on a grid infrastructure.

Teleradiology systems tackle the problem of transferring radiological images between medical image workstations for facilitating different medical activities, e.g., diagnosis, treatment and follow up a patient, medical training, or consulting second opinion. Nowadays, m-Health (aka mobile health) is becoming popular because of high quality of mobile displays, although remains a work in progress. In this paper a mobile teleradiology system is reported, which main contribution is the development of a platform: (1) supported by a Grid infrastructure, (2) using biomedical ontologies for adding semantic annotations on medical images, and (3) supporting semantic and content-based image retrieval. Images are located physically in different repositories like; hospitals and diagnostic imaging centers. All these features make the system ubiquitous, portable, and suitable for m-Health services.

Examen psicométrico del IQ Test como herramienta de discriminación de individuos normales y talentosos en la población escolar chilena / Psychometric Examination of the IQ Test as a Tool of Discrimination of Normal and Talented Individuals in the Chilean School Population

Se presentan los resultados del proceso de adaptación del IQ Test del grupo Mensa Dinamarca, para aplicarlo en Chile y así discriminar grupos de capacidad intelectual diferenciada. Se aplicó el instrumento a dos muestras de estudiantes secundarios chilenos: 2994 (grupo normal) y 394 (grupo aventajado). El instrumento presenta adecuados índices de fiabilidad, confirmando la validez del constructo mediante análisis factoriales y de Rasch. La validez concurrente se constató al comparar los desempeños con otro test de inteligencia previamente estandarizado en la población escolar chilena. El instrumento logra diferenciar individuos en los dos grupos (normal y aventajado) y sus puntuaciones se correlacionan positivamente con el rendimiento en matemáticas. Se discuten las principales implicaciones del estudio para el sistema escolar chileno.

This article presents results from the process of adaption of the Mensa Denmark IQ Test in Chile. The test was adapted to discriminate between groups of Chilean students with different intellectual capacities. The instrument was applied to two samples of Chilean secondary students: 2994 (normal group) and 394 (advanced group). The instrument shows adequate levels of confidence, and the validity of the instrument was confirmed by means of factor analysis and Rasch analysis. Concurrent validity was established when comparing the performance of the Chilean school population in other types of previously standardized intelligence tests. This instrument is able to differentiate individuals in both groups (normal and advanced) and their scores correlate positively with their performance in mathematics. This article discusses the main implications of this study for the Chilean school system.

An automatic method for the enrichment of DICOM metadata using biomedical ontologies.

This work is a novel contribution for enriching medical images using semantic annotations with a strategy for unifying different ontologies and instances of DICOM medical files. We present the L-MOM library (Library for Mapping of Ontological Metadata) as a tool for making an automatic mapping between instances of DICOM medical files and different medical ontologies (e.g., FMA, RadLex, MeSH). The main contributions are: i) the domain independent L-MOM library which is able to integrate DICOM metadata with ontologies from different domains; ii) a strategy to automatically annotate DICOM data with universally accepted medical ontologies, and provide values of similarity between ontologies and DICOM metadata; and iii) a framework to traverse ontological concepts that characterized clinical studies of patients registered in the framework catalog.

Health assets for adolescents: opinions from a neighbourhood in Spain.

This study uses a health asset (HA) framework to explore current perspectives on health, wellbeing and their determinants amongst a group of 15-18-year-old adolescents living in the neighbourhood of Zaidin (Granada, Spain). The study was carried out in Summer 2011 using a qualitative approach. It included 20 semi-structured interviews, 2 focus groups with adolescents and 4 semi-structured interviews with key informants (adults who work with adolescents). Narrative data were analysed by means of content analysis methodology, considering the concept of health, HAs and how they are prioritized as dimensions for the analysis. The concept of health defined by adolescents involves physical, psychological and social dimensions. According to them, health is associated with happiness and quality of life. A range of HAs were identified and classified as internal (belonging to the adolescents) and external or contextual. Internal assets are classified into three types: personal traits (assets of 'being'), behaviour (assets of 'doing') and social resources which contribute to their feeling of health and well-being (assets of 'having'). The latter connects internal and external assets. The classification of HAs ('being', 'doing' and 'having') proposed in this study provides a useful starting framework of thinking about how these assets could be organized to support the development of health promotion programmes. The study highlights the opportunity for public policy to contribute to the improvement of the conditions and local scenarios that improve the possibilities for positive connections at the community level.

Mauritia flexuosa Presents In Vitro and In Vivo Antiplatelet and Antithrombotic Activities.

Fruit from the palm Mauritia flexuosa is one of the most important species in Peru, Venezuela, Brazil, Colombia, Bolivia, and Guyana. The present study aimed to investigate the antiplatelet and antithrombotic activities of oil extracted from Mauritia flexuosa. The fatty acid contents were determined by gas chromatography-mass spectrometry. Oil extract of peel of Mauritia flexuosa was extracted by soxhlet extraction. The oil extract inhibited platelet secretion and aggregation induced by ADP, collagen, and TRAP-6 by a concentration-dependent way (0.1 to 1 mg/mL) without the participation of the adenylyl cyclase pathway and diminished platelet rolling and firm adhesion under flow conditions. Furthermore, the oil extract induced a marked increase in the rolling speed of leukocytes retained on the platelet surface, reflecting a reduction of rolling and less adhesion. At the concentrations used, the oil extract significantly decreased platelet release of sP-selectin, an atherosclerotic-related inflammatory mediator. Oil extract inhibited thrombus growth at the same concentration as that of aspirin, a classical reference drug. Finally, the data presented herein also demonstrate for the first time to our knowledge the protective effect of oil extracted from Mauritia flexuosa on platelet activation and thrombosis formation.

Caracterización molecular de materiales cultivados de gulupa (Passiflora edulis f. edulis) / Molecular characterization of cultivated materials of gulupa (Passiflora edulis f. edulis) / Caracterização molecular de materiais cultivados de gulupa (Passiflora edulis f. edulis)

Objetivo. Caracterizar mediante marcadores moleculares RAM (Random Amplified Microsatellite) la diversidad genética de materiales cultivados de gulupa (Passiflora edulis f. edulis), colectados en los departamentos de Boyacá, Cundinamarca y Huila. Materiales y métodos. Hojas jóvenes y en buen estado fitosanitario fueron colectadas en fincas productoras de gulupa, para la extracción de ADN y caracterización mediante marcadores moleculares RAM, de acuerdo con el protocolo descrito por Hantula (1996). A partir de los perfiles de bandas obtenidos, se generaron datos binarios de presencia (1) y ausencia (0). Los datos fueron analizados con el programa estadístico NTSYS- pc versión 2.0, obteniéndose una matriz de similitud utilizando el coeficiente o índice de Dice. Resultados. Los marcadores RAM fueron eficientes para detectar polimorfismos en esta especie, en total fueron usados cuatro primers universales, con los cuales se obtuvo un polimorfismo de 88,8%. En términos generales con los marcadores RAM se evidenció una amplia diversidad genética distribuida en las zonas en las que se cultiva la gulupa en el país. En el presente estudio no se encontró una concordancia con la procedencia de las muestras por departamento o localidad. Conclusiones. Los materiales de gulupa evaluados en este estudio mostraron una alta diversidad genética (0,291-1), probablemente producto del método de propagación, de su procedencia diversa y el poco tiempo de establecimiento de los cultivos en el país.

Objective. To evaluate through RAM (Random Amplified Microsatellites) molecular markers the genetic diversity of cultivated materials of gulupa (Passiflora edulis f. edulis), collected in the departments of Boyacá, Cundinamarca and Huila. Materials and methods. Young and healthy leaves were collected from crop fields of gulupa for DNA extraction and characterization through RAM molecular markers, according to Hantula's protocol (1996). Binary data of the type presence/absence were collected from the electrophoretic profiles. Data were analyzed with NTSYS- pc- 2.0 statistical package, obtaining a similarity matrix using the Dice coefficient. Results. RAM markers were efficient in detecting polymorphism in this species. Four universal primers were used that produced 88.8% of polymorphism. In general terms, with the RAM molecular markers a high genetic diversity was detected in the areas where gulupa is cultivated in Colombia. In the present study no geographical relatedness was found with the accessions evaluated for department or locality. Conclusions. The materials of gulupa evaluated in this study showed a high genetic diversity (0.291-1), probably due to the propagation method, its diverse provenances and the short time of establishment of the culture in Colombia.

Objetivo. Caracterizar por marcadores moleculares RAM (Random Amplified Microsatellite) a diversidade genética dos materiais cultivados de gulupa (Passiflora edulis f. edulis), coletados nos departamentos de Boyacá, Cundinamarca e Huila. Materiais e métodos. Folhas jovens e em bom estado fitossanitário foram coletadas em fazendas produtoras de gulupa para extração de ADN e caracterização por marcadores moleculares RAM, de acordo com o protocolo descrito por Hantula (1996). Dos perfis de bandas obtidos foram gerados dados binários de presença (1) e ausência (0). Os dados foram analisados pelo programa estatístico NTSYS-pc versão 2.0, produzindo uma matriz de similaridade usando o coeficiente ou índice de Dice. Resultados. Os marcadores RAM foram eficientes na detecção de polimorfismos nesta espécie, foram utilizados quatro primers universales, com os quais se obteve um polimorfismo de 88,8%. No geral, com os marcadores RAM revelou-se uma ampla diversidade genética distribuída em áreas onde se cultiva a gulupa no país. O presente estudo não encontrou uma correspondência com a origem das amostras por departamento ou localidade. Conclusões. Os materiais de gulupa avaliados neste estudo mostraram alta diversidade genética (0,291-1), provavelmente como resultado do método de propagação, de sua origem diversa e ao pouco tempo de estabelecimento dos cultivos no país.

A physical activity questionnaire: reproducibility and validity.

This study evaluates the Quantification de L'Activite Physique en Altitude chez les Enfants (QAPACE) supervised self-administered questionnaire reproducibility and validity on the estimation of the mean daily energy expenditure (DEE) on Bogotá's schoolchildren. The comprehension was assessed on 324 students, whereas the reproducibility was studied on a different random sample of 162 who were exposed twice to it. Reproducibility was assessed using both the Bland-Altman plot and the intra-class correlation coefficient (ICC). The validity was studied in a sample of 18 girls and 18 boys randomly selected, which completed the test - re-test study. The DEE derived from the questionnaire was compared with the laboratory measurement results of the peak oxygen uptake (Peak VO2) from ergo-spirometry and Leger Test. The reproducibility ICC was 0.96 (95% C.I. 0.95-0.97); by age categories 8-10, 0.94 (0.89-0. 97); 11-13, 0.98 (0.96- 0.99); 14-16, 0.95 (0.91-0.98). The ICC between mean TEE as estimated by the questionnaire and the direct and indirect Peak VO2 was 0.76 (0.66) (p<0.01); by age categories, 8-10, 11-13, and 14-16 were 0.89 (0.87), 0.76 (0.78) and 0.88 (0.80) respectively. The QAPACE questionnaire is reproducible and valid for estimating PA and showed a high correlation with the Peak VO2 uptake. Key pointsThe presence of a supervisor, the limited size of the group with the possibility of answering to their questions could explain the high reproducibility for this questionnaire.No study in the literature had directly addressed the issue of estimating a yearly average PA including school and vacation period.A two step procedure, in the population of schoolchildren of Bogotá, gives confidence in the use of the QAPACE questionnaire in a large epidemiological survey in related populations.

Anticuerpos antineutrófilos en vasculitis y mesenquimopatías / Antineutrophil antibodies in vasculitis and mesenchymopathies

Los ANCA son anticuerpos dirigidos contra proteínas de los gránulos citoplasmáticos de los neutrófilos. En la actualidad se describe un grupo de vasculitis sistémicas asociadas a los ANCA, tales como granulomatosis de Wegener (GW), poliangeítis microscópica y síndrome de Churg-Strauss. En ellas, los anticuerpos antineutrófilos constituyen un marcador serológico. En el presente trabajo se analizaron las patologías presentes en pacientes ANCA (+), observándose un 61 por ciento de casos con diagnóstico de granulomatosis de Wegener, en los cuales los títulos serológicos disminuyeron con tratamiento. La mesenquimopatía más encontrada correspondió al LES, en la cual los títulos fueron menores a los de los pacientes con GW. Estos resultados demuestran que los anticuerpos antineutrófilos son un elemento importante en el diagnóstico de algunas vasculitis sistémicas y que además tendrían un rol como marcador de actividad en ellas

Síndrome hiper IgE: aspectos clínicos e inmunopatogenia / Hyper IgE syndrome: clinical aspects and immunopatogenics

El síndrome hiper IgE es una inmunodeficiencia primariaque se caracteriza por infecciones bacterianas recurrentes cutáneas y sinopulmonares y niveles séricos de IgE elevados (>2.000 Ul/ml). Se revisaron los hallazgos clínicos, laboratorio característico, inmunopatogenia y terapéutica de este síndrome