An assessment of infant mortality rates in Colombia, 1980-2009 / Una evaluación de las tasas de mortalidad infantil en Colombia, 1980-2009

Abstract Purpose: The infant mortality rate is a key indicator of human welfare and development. However, in Colombia, the Departamento Administrativo Nacional de Estadística has set the registered rate for 2009 as 13.69 per 1,000 live births, while the estimated rate is 20.13, suggesting the presence of inconsistencies in the data, as in many other transitional economies. Objective: To set the record straight on Colombia's Infant mortality rate reporting since 1980 by using all available data that have recently become public. Methods: The study analyzes 8,636,510 records of live births (1998-2009) and 443,338 records of deaths (1979-2009), and considers information from all available sources: births and death registries, census data, Departamento Administrativo Nacional de Estadística, and Profamilia surveys. First, following a descriptive analysis, an exponential function is used to estimate the Infant mortality rates in Colombia for 1980-2009 while resolving internal inconsistencies in the data from all sources. The objective is to evaluate the infant mortality rate in Colombia, 1980-2009. Results: The analysis demonstrates that the registered and the estimated rates for 2009 are incompatible since they follow inconsistent long-term rates of decline in Infant mortality rate. While the registered rate underestimates the real situation, the estimated rate appears to grossly overestimate it. Analyses, based on other sources, put the Infant mortality rate between 15.81 and 17.58 in 2009, with rates of decline between 3.0 and 5.0 percent for the period 1980-2009. Conclusions: The study concludes that during the period 1980-2009, the Infant mortality rate for Colombia on average fell from about 54 to about 17, suggesting a long-term annual rate of decline of about 4.0 percent.

Resumen Propósito: La Tasa de Mortalidad Infantil es un indicador clave del bienestar y desarrollo humano. Sin embargo, en Colombia el Departamento Administrativo Nacional de Estadística reporta una tasa de mortalidad infantil registrada para 2009 de 13.69 por cada 1,000 nacidos vivos, mientras que, la tasa estimada es de 20.13 para el mismo año, como en muchas economías de transición, lo que sugiere la presencia de datos inconsistentes. El objetivo fue determinar la tasa de mortalidad infantil de Colombia desde 1980 a 2009, con los datos disponibles y publicados recientemente. Métodos: El estudio analiza 8 636 510 de registros individuales de nacidos vivos (1998-2009) y 443 338 registros individuales de mortalidad (1979-2009). Además, se incluyen todas las fuentes disponibles: nacimientos y defunciones registrados del Departamento Administrativo Nacional de Estadística (DANE), datos censales, y la Encuesta Nacional de Demografía y Salud (ENDS) de Profamilia Colombia. En primer lugar, tras un análisis descriptivo, se utilizó una función exponencial para estimar las tasas de mortalidad infantil en Colombia para 1980-2009 mientras se resuelven las incoherencias internas en los datos de todas las fuentes, con el objetivo de evaluar la tasa de mortalidad infantil en Colombia 1980-2009. Resultados: El análisis mostró que las tasas registradas y estimadas para 2009 eran incompatibles, debido a que la tasa de descenso de los nacimientos y las defunciones a lo largo del tiempo también eran inconsistentes. Si bien la tasa registrada de 13.69, estaba subestimada frente a la situación real, la tasa estimada de 20.13, parecía estar demasiado sobreestimada. Los análisis basados en otras fuentes muestran que la tasa de mortalidad infantil se encuentra entre 15.81 y 17.58 en 2009, con tasas de descenso anual entre un 3.0 y el 5.0 por ciento, para el período 1980-2009. Conclusiones: El estudio concluye que, durante el período 1980-2009 la tasa de mortalidad infantil para Colombia se redujo de 54 a 17 muertes por mil nacidos vivos, lo que sugiere una tasa anual de descenso aproximada para el período de 4.0 por ciento.

Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis

Abstract BACKGROUND: Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relation. However, beyond genital psoriasis, the importance of the disease's distribution patterns has not been considered. OBJECTIVES: To research sexual function in psoriasis patients and investigate the roles of anxiety, depression and psoriasis' distribution patterns in sexual dysfunction. METHODS: A comparative study matched for sex and age was performed. Eighty patients with moderate to severe psoriasis and 80 healthy controls were included. The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. RESULTS: Psoriasis was associated with sexual dysfunction, odds ratio=5.5 (CI 95% 2.6-11.3; p<0.001). Certain distribution patterns of psoriasis, involving specific body regions, were associated with an increase in sexual dysfunction in the group presenting the disease, odds ratio 7.9 (CI 95% 2.3-33.4; p<0.001). Multivariate logistic regression analysis identified anxiety and depression, and the involvement of these specific areas, as possible independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. CONCLUSION: This study identifies body areas potentially related to sexual dysfunction, independently of anxiety and depression, in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when choosing the treatment for psoriasis patients. .

Movilidad, accidentalidad por tránsito y sus factores asociados en estudiantes universitarios de Guatemala / Mobility, traffic accidents, and associated factors among Guatemalan university students / Mobilidade, acidentes de trânsito e fatores associados entre estudantes universitários da Guatemala

El objetivo fue identificar y cuantificar la asociación entre la intensidad de exposición (km/año recorridos), la accidentalidad y sus factores asociados en universitarios de Guatemala. Se realizó un estudio trasversal durante el curso 2010-2011, sobre una muestra de 1.016 conductores, quienes cumplimentaron un cuestionario autoadministrado que valoraba: patrones de movilidad, uso de dispositivos de seguridad, estilos de conducción y accidentalidad. Se obtuvieron asociaciones positivas entre la intensidad de exposición y la mayor implicación en circunstancias de riesgo al volante (coeficiente de regresión ajustado de 3,25, IC95%: 2,23-4,27, para las mayores exposiciones). Tanto una mayor implicación en tales circunstancias, como una mayor edad, fueron las variables más fuertemente asociadas con la mayor accidentalidad. Pese a que la intensidad de exposición se asocia positivamente con una mayor accidentalidad, se constató que la mayor parte de dicha asociación está mediada por una mayor implicación en circunstancias de riesgo al volante.

The aim of this study was to identify and quantify the association between the amount of driving (km/year), traffic accidents, and other factors among university students in Guatemala. A cross-sectional study was performed during the 2010-2011 school year in a sample of 1,016 drivers who completed a self-administered questionnaire that assessed mobility patterns, use of safety accessories, driving style, and automobile crashes. The results showed a positive association between amount of driving and greater involvement in risky driving (adjusted regression coefficient 3.25, 95%CI: 2.23-4.27, for the highest level of exposure). More frequent involvement in risky driving and older age showed the strongest associations with traffic accidents. Although the amount of driving was positively associated with a higher accident rate, most of this association was found to be mediated by involvement in risky driving practices.

O objetivo foi identificar e quantificar a associação entre a intensidade de exposição (km/anos percorridos), a acidentalidade e os seus fatores em universitários da Guatemala. Realizou-se um estudo transversal durante o curso 2010-2011 sobre uma amostra de 1.016 condutores de veículos, que responderam a um questionário autoadministrado que valorizava: padrões de mobilidade, uso de dispositivos de segurança, maneira de condução e acidentalidade. Obtiveram-se associações positivas entre intensidade de exposição e maior implicância em circunstâncias de risco ao conduzir (coeficiente de regressão ajustado a 3,25; IC95%: 2,23-4,27, para as maiores exposições). Tanto a maior implicância em ditas circunstâncias como uma maioridade foram as variáveis mais fortemente associadas com a maior acidentalidade. Apesar de a intensidade de exposição ser associada positivamente com uma maior acidentalidade, estabelecemos que a maior parte da dita associação está mediada pela maior implicância em circunstâncias de risco ao conduzir.