Mental disorders in Mexico 1990-2021. Results from the Global Burden of Disease 2021 study.

BACKGROUND: Mental disorders are one of the main causes of years lived with disability, although there is a lack of recent estimates of their magnitude. OBJECTIVE: To report the trends of mental disorders prevalence, years lived with disability and years of healthy life lost by sex, age and state in Mexico. MATERIAL AND METHODS: The Global Burden of Disease database for Mexico was used. RESULTS: There were an estimated 18.1 million persons with some mental disorder in 2021, which represented an increase of 15.4% in comparison with 2019. Depressive and anxiety disorders did significantly increase between 2019 and 2021, which is possibly related to COVID-19, the confinement and the situations of grief experienced during the pandemic. CONCLUSIONS: Mental disorders have considerably increased since the only national mental health survey that used diagnostic criteria to evaluate their prevalence. It is important to invest in epidemiological studies, prevention and care of mental disorders, which are among the leading causes of years lived with disability in the country.

ANTECEDENTES: Los trastornos mentales constituyen una de las principales causas de años vividos con discapacidad, si bien no se dispone de estimaciones recientes sobre su magnitud. OBJETIVO: Reportar las tendencias de prevalencia de trastornos mentales, los años vividos con discapacidad y los años de vida saludables perdidos por sexo, edad y entidad federativa de México. MATERIAL Y MÉTODOS: Se utilizó la base de datos para México del Global Burden of Disease. RESULTADOS: Se calcularon 18.1 millones de personas con algún trastorno mental en 2021, que representaron un incremento de 15.4 % respecto a 2019. Los trastornos depresivos y de ansiedad aumentaron de manera notable entre 2019 y 2021, lo cual posiblemente esté relacionado con COVID-19, el confinamiento y los duelos vividos durante la pandemia. CONCLUSIONES: Los trastornos mentales se han incrementado considerablemente desde la única encuesta nacional de salud mental que utilizó criterios diagnósticos para evaluar las prevalencias. Es importante invertir en estudios epidemiológicos, prevención y atención de los trastornos mentales, los cuales se encuentran entre las primeras causas de años vividos con discapacidad en el país.

Validating the Coronavirus Anxiety Scale in a Colombian sample.

The present instrumental study evaluated the psychometric properties of the Coronavirus Anxiety Scale with 421 Colombian adults in full lockdown of coronavirus. The reliability was excellent, obtained through the Cronbach's Alpha coefficient (α = 0.83). The results of the confirmatory factor analysis identified satisfactory indicators for the scale's one-dimensional model. The correlations obtained in the discriminant analysis of the items have a moderate level of correlation with values between 0.74 and 0.81. These findings demonstrate that the Coronavirus Anxiety Scale is a valid and reliable instrument to evaluate dysfunctional anxiety related to coronavirus in Colombian population.

Isotherm Theoretical Study of the AlxGa1-xAsySb1-y Quaternary Alloy Using the Regular Solution Approximation for Its Possible Growth via Liquid-Phase Epitaxy at Low Temperatures.

This work presents the theoretical calculation of isotherm diagrams for quaternary alloys of III-V semiconductor compounds with the form IIIxIII1-xVyV1-y. In particular, the isotherm diagrams for the AlxGa1-xAsySb1-y quaternary alloy at low temperatures were calculated (500 °C, 450 °C, 400 °C, and 350 °C). The AlxGa1-xAsySb1-y quaternary alloy was formed from four binary compounds such as GaAs, AlAs, AlSb, and GaSb, all with direct bandgaps. The regular solution approximation was used to find the quaternary isotherm diagrams, represented in four linearly independent equations, which were solved using Parametric Technology Corporation Mathcad 14.0 software for different arsenic and antimony atomic fractions. The results support the possible growth of layers via liquid-phase epitaxy in a range of temperatures from 500 °C to 350 °C, where the crystalline quality could be improved at low temperatures. These semiconductor layers could have applications for optoelectronic devices in photonic communications, thermophotovoltaic systems, and microwave devices with good crystalline quality.

Rate and management of tympanic membrane perforations in children with Down syndrome and middle ear disorder.

OBJECTIVE: To characterize the management and outcomes of observation versus surgical intervention of tympanic membrane (TM) perforations in children with Down syndrome (DS). In addition, to estimate the prevalence of TM perforations in children with DS. METHODS: Retrospective case review analysis of TM perforation rate in children with DS with history of tympanostomy tube (TT) insertion at a tertiary pediatric referral center. Patients were divided into observation or surgical intervention groups and then further evaluated for the type of intervention, the number of required procedures, and success rate of hearing improvement. Risk factors contributing to perforations were analyzed, including TT type, number of TT surgeries, and perforation size. RESULTS: The TM perforation rate in children with DS with TT history was 7.0 %. Tympanoplasty was performed in 41.5 % of perforated ears with a success rate of 53.1 %. There was no statistical difference between the surgical intervention and observation groups regarding perforation characteristics or TT number and type, but the surgical intervention cohort was older. Hearing improvement based on postoperative pure tone average (PTA) threshold was noted in the successful surgical intervention group. CONCLUSION: The rate of TM perforations in children with DS after TTs is comparable to the general population. Improved PTA thresholds were noted in the surgical success group influencing speech development. The overall lower success rate of tympanoplasty in patients with DS emphasizes the need to factor in the timing of surgical intervention based on the predicted age of Eustachian tube maturation.

Myosin filaments in smooth muscle cells do not have a constant length.

Myosin molecules from smooth muscle and non-muscle cells are known to self-assemble into side-polar filaments in vitro. However, the in situ mechanism of filament assembly is not clear and the question of whether there is a unique length for myosin filaments in smooth muscle is still under debate. In this study we measured the lengths of 16,587 myosin filaments in three types of smooth muscle cells using serial electron microscopy (EM). Sheep airway and pulmonary arterial smooth muscle as well as rabbit carotid arterial smooth muscle were fixed for EM and serial ultra-thin (50-60 nm) sections were obtained. Myosin filaments were traced in consecutive sections to determine their lengths. The results indicate that there is not a single length for the myosin filaments; instead there is a wide variation in lengths. The plots of observation frequency versus myosin filament length follow an exponential decay pattern. Analysis suggests that in situ assembly of myosin filaments in smooth muscle is governed by random processes of linear polymerization and de-polymerization, and that the dynamic equilibrium of these processes determines the observed length distribution.

Pearls & Oy-sters: Leber Hereditary Optic Neuropathy-Plus Masquerading as Neuromyelitis Optica Spectrum Disorder in a 2-Year-Old Child.

"Leber hereditary optic neuropathy (LHON-Plus)" is a phenotype of LHON that is characterized by extraocular neurologic manifestations, which may be the first manifestations of the disease.

Fragile X Syndrome in children.

Fragile X syndrome is caused by the expansion of CGG triplets in the FMR1 gene, which generates epigenetic changes that silence its expression. The absence of the protein coded by this gene, FMRP, causes cellular dysfunction, leading to impaired brain development and functional abnormalities. The physical and neurologic manifestations of the disease appear early in life and may suggest the diagnosis. However, it must be confirmed by molecular tests. It affects multiple areas of daily living and greatly burdens the affected individuals and their families. Fragile X syndrome is the most common monogenic cause of intellectual disability and autism spectrum disorder; the diagnosis should be suspected in every patient with neurodevelopmental delay. Early interventions could improve the functional prognosis of patients with Fragile X syndrome, significantly impacting their quality of life and daily functioning. Therefore, healthcare for children with Fragile X syndrome should include a multidisciplinary approach.

El síndrome de X frágil es causado por la expansión de tripletas CGG en el gen FMR1, el cual genera cambios epigenéticos que silencian su expresión. La ausencia de la proteína codificada por este gen, la FMRP, causa disfunción celular, llevando a deficiencia en el desarrollo cerebral y anormalidades funcionales. Las manifestaciones físicas y neurológicas de la enfermedad aparecen en edades tempranas y pueden sugerir el diagnóstico. Sin embargo, este debe ser confirmado por pruebas moleculares. El síndrome afecta múltiples aspectos de la vida diaria y representa una alta carga para los individuos afectados y para sus familias. El síndrome de C frágil es la causa monogénica más común de discapacidad intelectual y trastornos del espectro autista; por ende, el diagnóstico debe sospecharse en todo paciente con retraso del neurodesarrollo. Intervenciones tempranas podrían mejorar el pronóstico funcional de pacientes con síndrome de X frágil, impactando significativamente su calidad de vida y funcionamiento. Por lo tanto, la atención en salud de niños con síndrome de X frágil debe incluir un abordaje multidisciplinario.

Obtaining of Mg-Zn Co-Doped GaN Powders via Nitridation of the Ga-Mg-Zn Metallic Solution and Their Structural and Optical Properties.

Mg-Zn co-dopedGaN powders via the nitridation of a Ga-Mg-Zn metallic solution at 1000 °C for 2 h in ammonia flow were obtained. XRD patterns for the Mg-Zn co-dopedGaN powders showed a crystal size average of 46.88 nm. Scanning electron microscopy micrographs had an irregular shape, with a ribbon-like structure and a length of 8.63 µm. Energy-dispersive spectroscopy showed the incorporation of Zn (Lα 1.012 eV) and Mg (Kα 1.253 eV), while XPS measurements showed the elemental contributions of magnesium and zinc as co-dopant elements quantified in 49.31 eV and 1019.49 eV, respectively. The photoluminescence spectrum showed a fundamental emission located at 3.40 eV(364.70 nm), which was related to band-to-band transition, besides a second emission found in a range from 2.80 eV to 2.90 eV (442.85-427.58 nm), which was related to a characteristic of Mg-doped GaN and Zn-doped GaN powders. Furthermore, Raman scattering demonstrated a shoulder at 648.05 cm-1, which could indicate the incorporation of the Mg and Zn co-dopants atoms into the GaN structure. It is expected that one of the main applications of Mg-Zn co-doped GaN powders is in obtaining thin films for SARS-CoV-2 biosensors.

A point-of-care diagnostic test for aquaporin-4 antibody seropositive neuromyelitis optica.

BACKGROUND: Given the need for specialized laboratory techniques, diagnostic testing for serum antibodies to aquaporin-4, a protein associated with neuromyelitis optica spectrum disorder (NMOSD), is not globally accessible. We aimed to evaluate a novel point-of-care, filter paper-based test for serum AQP4 antibodies (AQP4-Ab). METHODS: Adults with AQP4-Ab seropositive NMOSD and seronegative controls (with other central nervous system demyelinating diagnoses) used lancets to place blood drops (∼1 mL) on filter paper cards. Samples were analyzed after an average of 9.4 days using transfected AQP4-GFP HEK293 cells, and results were compared to participants' prior serum AQP4-Ab test results by blinded laboratory staff. RESULTS: Of 40 participants (mean age 53.7 years; 83% female), 25 were cases and 15 were controls. The most common diagnosis of controls was multiple sclerosis (73%). The average NMOSD disease duration was 6.3 years. All AQP4-Ab seropositive participants were on disease modifying therapies at the time of participation. The point-of-care test yielded a sensitivity of 80% and specificity of 93% (positive and negative predictive values 95% and 74%). CONCLUSION: This point-of-care AQP4-Ab testing method may become a pragmatic option to diagnose AQP4-Ab seropositive NMOSD in difficult-to-reach settings. This method should be confirmed with other testing parameters and field tested in new populations.

Randomized Controlled Trials for Neuromyelitis Optica Spectrum Disorder: A Review of Trial Architecture.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing inflammatory disease that primarily affects the optic nerves and the spinal cord. Randomized controlled trials (RCTs) assessing treatments for NMOSD have only been performed in the past decade, and to date, there are 3 drugs approved by the US Food and Drug Administration (FDA) for antiaquaporin-4 immunoglobulin G seropositive NMOSD. This review assesses the characteristics and challenges of RCTs when evaluating treatments for NMOSD. REVIEW SUMMARY: We conducted a review using the terms ("neuromyelitis optica" OR "NMO" OR "NMOSD") AND "clinical trial" in any language on March 28, 2021. Seven RCTs were included, and the trials' architecture was analyzed and synthesized. Overall, 794 subjects were randomized [monoclonal antibody intervention group, n= 493 (62.1%), placebo, n=196 (24.7%), and active control, n=105 (13.2%)]; 709 (89.3%) were females; and 658 (82.9%) were aquaporin-4 (AQP4) antibody seropositive. The primary outcome was time to relapse in 6/7 of the trials, and annualized relapse rate in the remaining one. Four RCTs used placebo in their design. Among the seven published RCTs, the trial design differed by the criteria used to define NMOSD relapse, selection of subjects, proportion of AQP4 immunoglobulin G seronegative patients, and baseline characteristics indicating NMO disease severity. CONCLUSIONS: Ethical considerations for the use of placebo should change in light of the approval of 3 therapies for seropositive NMOSD. Remaining challenges for clinical trials in NMOSD include the assessment of long-term safety and efficacy, standardization of trial design and endpoints, and head-to-head study designs.

["Mi Dragón Dormido" ("My Sleeping Dragon"), therapeutic and psychoeducational tool for the HIV/AIDS diagnosis disclosure to children and prevention of social stigma]. / "Mi Dragón Dormido", herramienta terapéutica y psicoeducativa para la revelación del diagnóstico de VIH/SIDA a niños y prevención del estigma social.

BACKGROUND: The World Health Organization and the American Academy of Pediatrics suggest disclose the HIV diagnosis to children. However, the disclosure of HIV/AIDS diagnosis to children and adolescents, it is not a consolidated practice in Colombia, often this occurs because caregivers do not have an adequate methodology to carry out this process. AIM: We present the efficiency components validation of "Mi dragon Dormido" history in the educational process and revelation ofAIDS diagnosis to boys and girls. METHOD: By means of purposive non-probability sampling, semi-structured interviews were conducted with 40 children, with an equal number of children who were seropositive (n = 20) and seronegative (n = 20) for HIV/ AIDS. A qualitative study with the approach of grounded theory and systematic design was conducted. We conducted the qualitative study through the NVivo software, with the codification type being Tree Nodes. RESULTS: The qualitative data provided necessary approximations to improve the content and design of the tool and showed that it reflects the reality of children and allows them to identify frequent fears and questions regarding to chronic health condition of HIV. CONCLUSIONS: These results provide important information to be considered in the process of diagnosis revelation and its management by health personnel.

Dense-body aggregates as plastic structures supporting tension in smooth muscle cells.

The wall of hollow organs of vertebrates is a unique structure able to generate active tension and maintain a nearly constant passive stiffness over a large volume range. These properties are predominantly attributable to the smooth muscle cells that line the organ wall. Although smooth muscle is known to possess plasticity (i.e., the ability to adapt to large changes in cell length through structural remodeling of contractile apparatus and cytoskeleton), the detailed structural basis for the plasticity is largely unknown. Dense bodies, one of the most prominent structures in smooth muscle cells, have been regarded as the anchoring sites for actin filaments, similar to the Z-disks in striated muscle. Here, we show that the dense bodies and intermediate filaments formed cable-like structures inside airway smooth muscle cells and were able to adjust the cable length according to cell length and tension. Stretching the muscle cell bundle in the relaxed state caused the cables to straighten, indicating that these intracellular structures were connected to the extracellular matrix and could support passive tension. These plastic structures may be responsible for the ability of smooth muscle to maintain a nearly constant tensile stiffness over a large length range. The finding suggests that the structural plasticity of hollow organs may originate from the dense-body cables within the smooth muscle cells.

Fragile X Syndrome in children

Fragile X syndrome is caused by the expansion of CGG triplets in the FMR1 gene, which generates epigenetic changes that silence its expression. The absence of the protein coded by this gene, FMRP, causes cellular dysfunction, leading to impaired brain development and functional abnormalities. The physical and neurologic manifestations of the disease appear early in life and may suggest the diagnosis. However, it must be confirmed by molecular tests. It affects multiple areas of daily living and greatly burdens the affected individuals and their families. Fragile X syndrome is the most common monogenic cause of intellectual disability and autism spectrum disorder; the diagnosis should be suspected in every patient with neurodevelopmental delay. Early interventions could improve the functional prognosis of patients with Fragile X syndrome, significantly impacting their quality of life and daily functioning. Therefore, healthcare for children with Fragile X syndrome should include a multidisciplinary approach.

El síndrome de X frágil es causado por la expansión de tripletas CGG en el gen FMR1, el cual genera cambios epigenéticos que silencian su expresión. La ausencia de la proteína codificada por este gen, la FMRP, causa disfunción celular, llevando a deficiencia en el desarrollo cerebral y anormalidades funcionales. Las manifestaciones físicas y neurológicas de la enfermedad aparecen en edades tempranas y pueden sugerir el diagnóstico. Sin embargo, este debe ser confirmado por pruebas moleculares. El síndrome afecta múltiples aspectos de la vida diaria y representa una alta carga para los individuos afectados y para sus familias. El síndrome de C frágil es la causa monogénica más común de discapacidad intelectual y trastornos del espectro autista; por ende, el diagnóstico debe sospecharse en todo paciente con retraso del neurodesarrollo. Intervenciones tempranas podrían mejorar el pronóstico funcional de pacientes con síndrome de X frágil, impactando significativamente su calidad de vida y funcionamiento. Por lo tanto, la atención en salud de niños con síndrome de X frágil debe incluir un abordaje multidisciplinario.

Los trastornos mentales en México 1990-2021. Resultados del estudio Global Burden of Disease 2021 / Mental disorders in Mexico 1990-2021. Results from the Global Burden of Disease 2021 study

Resumen Antecedentes: Los trastornos mentales constituyen una de las principales causas de años vividos con discapacidad, si bien no se dispone de estimaciones recientes sobre su magnitud. Objetivo: Reportar las tendencias de prevalencia de trastornos mentales, los años vividos con discapacidad y los años de vida saludables perdidos por sexo, edad y entidad federativa de México. Material y métodos: Se utilizó la base de datos para México del Global Burden of Disease. Resultados: Se calcularon 18.1 millones de personas con algún trastorno mental en 2021, que representaron un incremento de 15.4 % respecto a 2019. Los trastornos depresivos y de ansiedad aumentaron de manera notable entre 2019 y 2021, lo cual posiblemente esté relacionado con COVID-19, el confinamiento y los duelos vividos durante la pandemia. Conclusiones: Los trastornos mentales se han incrementado considerablemente desde la única encuesta nacional de salud mental que utilizó criterios diagnósticos para evaluar las prevalencias. Es importante invertir en estudios epidemiológicos, prevención y atención de los trastornos mentales, los cuales se encuentran entre las primeras causas de años vividos con discapacidad en el país.

Abstract Background: Mental disorders are one of the main causes of years lived with disability, although there is a lack of recent estimates of their magnitude. Objective: To report the trends of mental disorders prevalence, years lived with disability and years of healthy life lost by sex, age and state in Mexico. Material and methods: The Global Burden of Disease database for Mexico was used. Results: There were an estimated 18.1 million persons with some mental disorder in 2021, which represented an increase of 15.4% in comparison with 2019. Depressive and anxiety disorders did significantly increase between 2019 and 2021, which is possibly related to COVID-19, the confinement and the situations of grief experienced during the pandemic. Conclusions: Mental disorders have considerably increased since the only national mental health survey that used diagnostic criteria to evaluate their prevalence. It is important to invest in epidemiological studies, prevention and care of mental disorders, which are among the leading causes of years lived with disability in the country.

Validación de las propiedades psicométricas de la Escala de Personalidad Tipo D en adultos colombianos

La personalidad tipo D se refiere a la vulnerabilidad frente al estrés psicológico, la cual se expresa en dos componentes: la afectividad negativa (AN) y la inhibición social (is), que pueden desencadenar un estado de estrés psicosocial que afecta la salud. El objetivo de este estudio fue analizar las propiedades psicométricas de la Escala de Personalidad Tipo D (DS-14) en población adulta colombiana. La muestra estuvo conformada por 456 adultos (41.7 % hombres y 58.3 % mujeres) colombianos entre los 18 y 86 años. El coeficiente de fiabilidad para las dos subescalas de la DS-14 fue de .73 (AN) y .72 (IS), y .79 para el puntaje total. Se analizó la validez concurrente con medidas de estrategias de afrontamiento resiliente y afrontamiento religioso. Los resultados evidencian validez interna y externa, dados los índices del análisis factorial exploratorio y confirmatorio.

Type D personality refers to vulnerability to psychological stress, which is expressed in two components: negative affectivity (NA) and social inhibition (si), which can trigger a state of psychosocial stress that affects health. The aim of this study was to analyze the psychometric properties of the Type D Personality Scale (DS-14) in the Colombian adult population. The sample consisted of 456 colombian adults (41.7 °% men and 58.3 °% women) between 18 and 86 years of age. The reliability coefficient for the two subscales of the DS-14 was .73 (NA) and .72 (SI), and .79 for the total score. Concurrent validity was analyzed with measures of resilient coping strategies and religious coping. The results show internal and external validity given the indices of the exploratory and confirmatory factor analysis.

Validación de las propiedades psicométricas de la escala breve de estrategias resilientes en adultos colombianos / Validation of the psychometric properties of the Brief Resilient Coping Scale (BRCS) in Colombian adults

Resumen La resiliencia es la competencia de afrontamiento y adaptación a las condiciones estresantes que puede experimentar una persona. Se puede expresar a través de varias estrategias como el optimismo, la perseverancia, la creatividad y el crecimiento positivo frente a la adversidad. Esta investigación tuvo como objetivo analizar las propiedades psicométricas de la Escala Breve de Estrategias Resilientes (BRCS) en población adulta colombiana. La muestra estuvo conformada por 456 adultos colombianos (41.7 % hombres y 58.3 % mujeres) entre los 18 y los 86 años (M = 46.99). El coeficiente de fiabilidad para el puntaje total de las dos subescalas de la BRCS fue de .77. Se corroboró la validez del constructo a través de la bondad de ajuste del modelo de un factor y la correlación entre los cuatro ítems, por el que se confirmó la estructura del modelo propuesto por Sinclair y Wallston (2004). Se analizó la validez concurrente con medidas de afrontamiento religioso y personalidad Tipo D. Se efectuó un análisis de la discriminación de los reactivos a través del coeficiente de correlación biserial, que indicó que las correlaciones del ítem con la escala total tienen un nivel de discriminación excelente, con valores entre .740 y .807. Los resultados muestran correlaciones significativas entre la resiliencia y el afrontamiento religioso positivo, índices de confiabilidad interna aceptables y consistencia interna, dados los índices del análisis factorial confirmatorio. Se concluye que la evidencia sugiere que la escala BRCS es un instrumento válido y confiable para la evaluación de la capacidad de resiliencia en adultos colombianos.

Abstract Resilience is the ability to cope and adapt to stressful situations that a person may experience. This ability can be expressed through several strategies such as optimism, perseverance, creativity, and positive growth from adversity. Considering the few studies on this subject in the Latin American context and, therefore, the difficulties in evaluating resilient strategies in adults, this research considered to analyze the psychometric characteristics of the Brief Resilient Strategies Scale (BRCS). This study aimed to analyze the psychometric properties of the "Brief Resilient Coping Scale (BRCS)" in the Colombian adult population. The sample consisted of 456 Colombian adults (41.7 % men and 58.3 % women) between 18 and 86 years old (M = 46.99). The reliability coefficient for the total score of the two BRCS subscales was .77. The construct validity was confirmed by goodness of fit results for applying a one-factor model to the scale and the correlation between the four items, confirming the structure of the model proposed by Sinclair y Wallston (2004), the initial solution of a factor was confirmed, with the same items loading the same factor and with factorial weights greater than .3. Likewise, all the values of the goodness of fit indices are within the accepted ranges for a good fit of the model. That is, the data fit the factorial model well. The concurrent validity was analyzed with measures of religious coping and type D personality. Positive correlations of the BRCS scale were found with positive religious coping of the RCOPE, indicating that a greater resilience, more expression of a sense of spirituality. In the same way, the BRCS scale correlates with the DS-14 scale, indicating that a greater resilience, less tendency to experience negative emotions such as dysphoria, tension, worry, irritability, and anger more extensively over time. In addition, the correlations indicated that a higher resilience, lower vulnerability to psychological stress with experiences of strong negative emotions and inhibition of their expression in interaction with other people. The results of the criterion validity suggest that people who use resilient strategies and religious coping are protective factors for the physical and mental health of the adult population, in such a way that people with higher levels of resilience may have a greater expression of a sense spiritual. Likewise, the most resilient subjects use variables such as satisfaction with life, humor, perceived personal competence, optimism, among others, indicative of a heightened sense of internal coherence. Also, the subjects who demonstrated greater resilience capacity were less vulnerable to experiencing negative affect and social inhibition. In general terms, these results suggest that the use of resilient strategies is related to constructs that are theoretically expected from a clinical and mental health perspective. The results show significant correlations between resilience and positive religious coping, acceptable internal reliability indices and internal consistency given the confirmatory factor analysis indices. An item discrimination analysis was performed through the biserial correlation coefficient, the correlations of the item with the total scale have an excellent level of discrimination, with values between .740 and .807. For data analysis, IBM SPSS Software®, Version 25, the R for Statistical Computing program (R Project, 2019) and LISREL 8.80 was used. The evidence suggests that the BRCS scale is a valid and reliable instrument for assessing resilience capacity in Colombian adults. In general, it was found that the BRCS has good psychometric properties in the various countries where it has been evaluated, for all the population groups analyzed, with only significant differences between men and women.

[Perception of adolescent pregnancy in the Department of North Santander, Colombia]. / Percepción del embarazo adolescente en el Departamento Norte de Santander, Colombia.

OBJETIVE: Analyze the perception of adolescent pregnancy in the Department of North Santander. METHOD: A descriptive cross-sectional study was conducted with 406 adolescent mothers between 10 and 19 years old in 6 sub-regions of the department. We used a structured survey and the Statistical Package for the Social Sciences (SPSS; Version No. 23) was employed for the data tabulation. RESULTS: 69 % of adolescents believe that unplanned pregnancy is associated with the lack of sexual education. 66 % say that it is preventable with the use of contraceptive methods. It is known that unwanted pregnancies are the main cause of school dropouts for 62 % of adolescents. DISCUSSION: Ensuring greater access to sex education and facilitating the free and easy access to contraception can reduce the problem of teen pregnancy.

OBJETIVO: Analizar la percepción del embarazo adolescente en el Departamento Norte de Santander. MÉTODO: Se realizó una investigación descriptiva de corte transversal con 406 madres adolescentes entre 10 y 19 años pertenecientes a las 6 subregiones del departamento. Se aplicó una encuesta estructurada y se tabularon los datos en el Paquete Estadístico para las Ciencias Sociales (SPSS [Statical Package for Social Sciencies]; versión No.23). RESULTADOS: El 69 % de las adolescentes considera que la falta de educación sexual está asociada al embarazo no planificado. El 66 % reconoce que los embarazos no planificados se pueden prevenir con el uso de métodos anticonceptivos, pues los embarazos indeseados son la principal causa de deserción escolar para un 62 % de las adolescentes. DISCUSIÓN: La garantía de un mayor acceso a la educación sexual integral junto con el acceso libre y fácil a los métodos anticonceptivos puede reducir la problemática del embarazo adolescente.

Aging and Erectile Dysfunction.

INTRODUCTION: Erectile dysfunction (ED) has been identified as the most common sexual problem that affects mainly men older than 40 years. According to this, there is a strong evidence linking ED with a number of medical conditions and related risk factors that had been described in the literature, yet there is limited information about the specific mechanism involved in the establishment of ED among healthy older men. AIM: The purpose of this study is to review the literature and mainly focus on the basic physiologic and vascular alterations and morphologic changes related to aging and its related risk factors, summarizing the main and the latest findings in basic research of tissue remodeling process involved in ED pathophysiology. METHODS: Data from the pertinent literature were examined to inform our conclusions. MAIN OUTCOME MEASURE: This article defines the morphologic and physiologic mechanisms involved in the process of aging, which play a key role in the development of sexual dysfunction. RESULTS: ED has been considered as a nonlife-threatening condition, but the recognition of its multiple comorbid conditions, the importance of aging process over the male sexual performance among them its relation with vascular and nitric oxide content alteration, as well as penile morphologic changes, and the fact that it is a widespread under-reported disease, have established the need of an early diagnosis and treatment of this common sexual problem within the general male population. CONCLUSION: In this case, morphologic and physiologic mechanisms that are involved in the aging process play a key role in the development of sexual dysfunction in the absence of any other clinical or medical condition.

"Mi Dragón Dormido", herramienta terapéutica y psicoeducativa para la revelación del diagnóstico de VIH/SIDA a niños y prevención del estigma social / "Mi Dragón Dormido" ("My Sleeping Dragon"), therapeutic and psychoeducational tool for the HIV/AIDS diagnosis disclosure to children and prevention of social stigma

INTRODUCCIÓN: La Organización Mundial de la Salud y la Académica Americana de Pediatría sugieren revelar el diagnóstico de VIH a niños. Sin embargo, esto no es una práctica consolidada en Colombia; a menudo esto ocurre porque los cuidadores no tienen una metodología adecuada para llevar a cabo este proceso. OBJETIVO: Se presenta la evaluación de la eficacia de la historia "Mi Dragón Dormido" para el proceso de educación y revelación del diagnóstico de VIH/SIDA a niños. MÉTODO: Mediante muestreo no probabilístico intencional; se administraron entrevistas semiestructuradas a 40 niños, seropositivos (n = 20) y seronegativos (n = 20) para VIH/SIDA. Se trató de un estudio cualitativo y diseño sistemático. Se realizó análisis cualitativo mediante el software NVivo 10 con codificación tipo Nodos de Árbol. RESULTADOS: Los datos cualitativos aportaron aproximaciones necesarias para mejorar el contenido y el diseño de la herramienta e indicaron que refleja la realidad de los niños y permite identificar temores y preguntas frecuentes frente a la condición crónica de salud del VIH. CONCLUSIONES: Estos resultados aportan información importante a considerar en el proceso de revelación del diagnóstico y su manejo por parte del personal de salud.

BACKGROUND: The World Health Organization and the American Academy of Pediatrics suggest disclose the HIV diagnosis to children. However, the disclosure of HIV/AIDS diagnosis to children and adolescents, it is not a consolidated practice in Colombia, often this occurs because caregivers do not have an adequate methodology to carry out this process. AIM: We present the efficiency components validation of "Mi dragon Dormido" history in the educational process and revelation ofAIDS diagnosis to boys and girls. METHOD: By means of purposive non-probability sampling, semi-structured interviews were conducted with 40 children, with an equal number of children who were seropositive (n = 20) and seronegative (n = 20) for HIV/ AIDS. A qualitative study with the approach of grounded theory and systematic design was conducted. We conducted the qualitative study through the NVivo software, with the codification type being Tree Nodes. RESULTS: The qualitative data provided necessary approximations to improve the content and design of the tool and showed that it reflects the reality of children and allows them to identify frequent fears and questions regarding to chronic health condition of HIV. CONCLUSIONS: These results provide important information to be considered in the process of diagnosis revelation and its management by health personnel.