Desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia, 1998-2019

Introducción: Anualmente se pierden 1,35 millones de vidas por causa de siniestros viales; su ocurrencia se ha relacionado, además de factores comportamentales, con desigualdades sociales. Objetivo: Analizar las desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia para el periodo 1998-2019. Materiales y métodos: Estudio ecológico a partir del análisis de las tasas de mortalidad ajustadas de los grupos poblacionales urbanos y rurales estratificados por sexo. Se hicieron análisis con regresión de Joinpoint y se calcularon medidas de desigualdad simple absoluta y relativa. Resultados: Se registraron 139 323 muertes por siniestros viales, en Colombia la tasa de mortalidad por esta causa se ha venido reduciendo. En contraste con las áreas rurales, en las áreas urbanas esta reducción es más significativa. Existen desigualdades en la mortalidad entre las áreas urbanas y rurales que han venido estrechándose. No obstante, en el caso de hombres y mujeres ha venido incrementándose. Discusión: La reducción de la tasa de mortalidad por siniestros viales sugiere que las intervenciones en seguridad vial han sido efectivas. La mayor mortalidad en hombres puede explicarse a partir de factores comportamentales. Las desigualdades urbano-rurales pueden estar relacionadas con las dinámicas de desarrollo. Conclusiones: Se registra una reducción en la tasa de mortalidad por siniestros viales, la cual es más significativa en áreas urbanas. Existen desigualdades urbano-rurales en la mortalidad por esta causa. Las políticas de seguridad vial deben partir de un enfoque integrador vinculado con otras agendas políticas.

Introduction: Annually, 1,35 million lives are lost due to road accidents; their occurrence has been related, in addition to behavioral factors, to social inequalities. Objective: To analyze urban-rural social inequalities in mortality from traffic accidents in Colombia from 1998-2019. Methods and materials: Ecological study based on the analysis of standardized mortality rates adjusted for age and sex of urban and rural population groups stratified by sex. Joinpoint regression analyses were performed, and absolute and relative simple inequality measures were calculated. Results: There were 139.323 deaths from road accidents; in Colombia mortality rates from this cause has been decreasing. In urban areas, the reduction is more significant than in rural areas. Disparities in mortality between urban and rural areas have been narrowing, however, in the case of men and women, they have been increasing. Discussion: Reducing the mortality rate from road accidents suggests that road safety interventions have been effective. Behavioral factors can explain the higher mortality in men. Urban-rural inequalities can be related to development dynamics. Conclusions: There is a significant reduction in the mortality rate due to road accidents in urban areas. There are urban-rural inequalities in mortality from this cause. Road safety policies must be based on an integrative approach linked to other political agendas.

Depression and associated psychosocial factors following a legal abortion in Mexico

Introduction: Scientific evidence from the United States and European countries shows that women who have had an induced abortion are not more likely to become depressed and several factors may confound this outcome. In contrast, in the case of Latin America, there are practically no studies in this regard due to restrictive legislation prevailing in the region. This paper aims to determine the prevalence of a probable major depressive episode (PMDE) in women who have legally terminated a pregnancy by way of public service in Mexico City and whether there are any psychosocial factors reported by the international literature associated with this outcome. Method: In a cross-sectional study, 274 women aged 15 years or older were interviewed two weeks after undergoing a medical abortion between November 2018 and November 2019. The Center for Epidemiological Studies Depression Scale 35-item version (CES-D-R35) was used to measure the PMDE in a structured interview. Results: The prevalence of a PMDE was 15.8%. Multivariate logistic regression was used for adjusted analysis. Perceived abortion stigma ( OR = 6.74, 95% CI = 3.29-13.82), child sexual abuse (OR = 2.23, 95% CI = 1.01-4.93), and previous childless pregnancies (OR = 6.07, 95% CI = 1.52-24.21) were associated with PMDE. Conclusions: The prevalence of PMDE is similar to or lower than that reported in studies with women who continued a pregnancy; post-abortion counseling and clinical considerations should include the impact that stigma and gender-based violence have on women's mental health.

Introducción: Evidencia científica proveniente de los Estados Unidos y los países europeos indica que las mujeres que han tenido un aborto inducido no tienen más probabilidades de deprimirse y que hay varios factores que pueden intervenir para confundir este resultado. En el caso de América Latina, prácticamente no existen estudios al respecto debido a las legislaciones restrictivas imperantes. El objetivo de este artículo es determinar la prevalencia de un probable episodio depresivo mayor (PEDM) en mujeres que interrumpieron legalmente un embarazo en un servicio público en la Ciudad de México, y si hay algunos factores psicosociales reportados por la literatura internacional asociados con el resultado. Método: En un estudio transversal, se entrevistó a 274 mujeres de 15 años o más dos semanas después de someterse a un aborto médico entre noviembre del 2018 y noviembre del 2019. Se utilizó la versión de 35 reactivos de la Escala de Depresión del Centro para Estudios Epidemiológicos (CES-D-R35) para medir el PEDM en una entrevista estructurada. Resultados: La prevalencia de PEDM fue de 15,8 %. Se utilizó una regresión logística multivariada para el análisis ajustado. El estigma percibido por el aborto (OR = 6.74, IC 95 % = 3.29-13.82), el abuso sexual infantil (OR = 2.23, IC 95 % = 1.01-4.93) y los embarazos previos sin hijos (OR = 6.07, IC 95 % = 1.52-24.21) se asociaron con un PMDE. Conclusiones: La prevalencia de PEDM es similar o menor que la reportada en estudios con mujeres que continuaron un embarazo; el asesoramiento posaborto y las consideraciones clínicas deben incluir el impacto que el estigma y la violencia de género tienen en la salud mental de las mujeres.

El binomio causalidad-azar: ¿principio explicativo del conocimiento científico en medicina? / The causality-chance binomial: explanatory principle of scientific knowledge in medicine?

Resumen Este ensayo cuestiona las verdades matemáticas como principio explicativo del conocimiento científico médico. Se analiza, en primer término, el concepto de normalidad actual basado en una distribución de valores probabilísticos, y se destacan sus limitaciones y equívocos para captar la complejidad de la condición humana. Los sistemas cerrados (juegos de azar), origen de la teoría de las probabilidades y del binomio causalidad-azar, se comparan con los sistemas abiertos propios del proceso vital y se argumentan sus diferencias extremas. Se destaca el despropósito de depositar en el binomio causalidad-azar el significado de asociaciones entre sucesos propios de la complejidad de la vida humana en salud y enfermedad. Se confrontan las características de la causalidad mecanicista (puntual, lineal, unidireccional, homogénea y fija), que equipara al organismo con una máquina y es la única explicación científica aceptada del acontecer de la vida humana, con las de la causalidad contextual (difusa, heterogénea, jerárquica, multidireccional y cambiante), que especifica diversos órdenes causales interactuantes que dan forma a la condición humana: el histórico, el social, el político, el económico, el cultural o el biológico, que representa una mirada escrutadora y penetrante de la complejidad de los seres humanos. Se concluye la superioridad de la causalidad contextual sobre la mecanicista, que abre posibilidades explicativas de sucesos vitales que suelen arrumbarse como «efectos del azar¼. Esta aproximación integradora a la complejidad humana puede enriquecer y fortalecer el método clínico, hoy degradado y en riesgo de extinción.

Abstract This essay questions mathematical truths as an explanatory principle of the medical scientific knowledge. It analyzes, in the first place, the current concept of normality based on a distribution of probabilistic values and its limitations and mistakes to capture the complexity of the human condition are highlighted. The closed systems (gambling) origin of the theory of probabilities and the binomial causality-chance are compared with open systems typical of the complexity of the vital process, and their extreme differences are argued. The nonsense of depositing in the causality-chance binomial the meaning of associations between events typical of the complexity of human life in health and disease is highlighted. The characteristics of mechanistic causality (punctual, homogeneous, linear, unidirectional and fixed), which equates the organism with a machine and is the only accepted scientific explanation of events of human life, are confronted with those of contextual causality (diffuse, heterogeneous, hierarchical, multidirectional and changing), which specifies various interacting causal orders that shape of human condition: the historical, the social, the political, the economical, the cultural or the biological that represents a scrutinizing and penetrating look at the complexity of human beings. It concludes the superiority of contextual causality over mechanistic causality that opens up explanatory possibilities of the vital events that are usually put away as "effects of chance". This integrative approach to the human complexity can enrich and strengthen the clinical method that is now degraded and at risk of extinction.

Contextual Fear Learning and Extinction in the Primary Visual Cortex of Mice / 神经科学通报·英文版

Fear memory contextualization is critical for selecting adaptive behavior to survive. Contextual fear conditioning (CFC) is a classical model for elucidating related underlying neuronal circuits. The primary visual cortex (V1) is the primary cortical region for contextual visual inputs, but its role in CFC is poorly understood. Here, our experiments demonstrated that bilateral inactivation of V1 in mice impaired CFC retrieval, and both CFC learning and extinction increased the turnover rate of axonal boutons in V1. The frequency of neuronal Ca2+ activity decreased after CFC learning, while CFC extinction reversed the decrease and raised it to the naïve level. Contrary to control mice, the frequency of neuronal Ca2+ activity increased after CFC learning in microglia-depleted mice and was maintained after CFC extinction, indicating that microglial depletion alters CFC learning and the frequency response pattern of extinction-induced Ca2+ activity. These findings reveal a critical role of microglia in neocortical information processing in V1, and suggest potential approaches for cellular-based manipulation of acquired fear memory.

A Virtual Reality Platform for Context-Dependent Cognitive Research in Rodents / 神经科学通报·英文版

Animal survival necessitates adaptive behaviors in volatile environmental contexts. Virtual reality (VR) technology is instrumental to study the neural mechanisms underlying behaviors modulated by environmental context by simulating the real world with maximized control of contextual elements. Yet current VR tools for rodents have limited flexibility and performance (e.g., frame rate) for context-dependent cognitive research. Here, we describe a high-performance VR platform with which to study contextual behaviors immersed in editable virtual contexts. This platform was assembled from modular hardware and custom-written software with flexibility and upgradability. Using this platform, we trained mice to perform context-dependent cognitive tasks with rules ranging from discrimination to delayed-sample-to-match while recording from thousands of hippocampal place cells. By precise manipulations of context elements, we found that the context recognition was intact with partial context elements, but impaired by exchanges of context elements. Collectively, our work establishes a configurable VR platform with which to investigate context-dependent cognition with large-scale neural recording.

Percepción subjetiva del esfuerzo, la ansiedad y la autoconfianza en jugadores de fútbol semiprofesionales / Rating of perceived exertion, anxiety and self-confidence in semi-professional soccer players

Resumen Objetivo: analizar la percepción subjetiva del esfuerzo y de los estados de ansiedad (cognitiva y somática), autoconfianza en jugadores de fútbol semiprofesionales. Método: han participado 18 jugadores españoles semiprofesionales con experiencia mínima de tres años en la categoría nacional (edad: 26.4 años, peso: 75.8 kg, altura: 181 cm) clasificados en dos porteros, tres defensas centrales, tres defensas laterales, cuatro centrocampistas, tres extremos y tres delanteros. Se analizaron 10 partidos (cinco como locales y cinco como visitantes) y se usó el cuestionario Competitive State Anxiety Inventory 2 y escala Category Ratio 10 de Borg para la percepción subjetiva del esfuerzo. Se realizó el test de análisis de la varianza de un factor (posición de juego) y t-test para muestras independientes (localización y rol). Resultados: se han obtenido diferencias significativas en estas variables psicofisiológicas en relación con las posiciones de juego, localización y rol de juego. Conclusión: en este estudio de caso, los jugadores con rol defensivo y los que juegan como visitantes tienen menor percepción subjetiva del esfuerzo y los atacantes presentan mayor ansiedad somática y autoconfianza previos a la competición deportiva.

Abstract Objetive: To analyze the rate of perceived exertion and anxiety states (cognitive and somatic), self-confidence in semi-professional soccer players. Method: 18 semi-professional Spanish soccer players with at least 3 years' experience in the national category participated (age: 26.4; weight: 75.8 kg; height: 181 cm), classified as two goalkeepers, three central defenders, three internal defenders, four midfielders, three wingers, three forwards. Ten matches were analyzed (five at home and five as visitors) and the Competitive State Anxiety Inventory 2 questionnaire and Borg's Category Ratio scale 10 for the rate of perceived exertion were used. A one-way analysis of variance test (game position) and t-test for independent samples (location and role) were performed. Results: Significant differences have been obtained in these psycho-physiological variables in relation to game positions, location, and game role. Conclusion: In this case report, players with a defensive role and those who play as visitors have lower rate of perceived exertion and attackers have higher somatic anxiety and self-confidence prior to the sports competition.

Factores contextuales de las señales ateroscleróticas tempranas en adolescentes aparentemente sanos / Contextual factors of early atherosclerotic signals in apparently healthy adolescents

Introducción: La exploración e identificación de los factores contextuales del proceso aterosclerótico desde las edades tempranas presenta vacío de conocimiento en términos de mecanismos y causas. En la atención primaria de salud existen las condiciones requeridas para la identificación de los adolescentes con factores de riesgo aterogénico y en la cual resulta más fácil comprender el contexto de la enfermedad. Objetivo: Determinar la influencia de los factores contextuales sobre la presencia de señales ateroescleróticas tempranas en adolescente aparentemente sanos. Métodos: Estudio descriptivo de corte transversal. Se utilizaron estadísticas descriptivas. Se aplicó análisis de correlaciones canónicas y se elaboraron árboles de decisión. Resultados: Los factores de riesgo aterosclerótico que predominaron para ambos sexos fueron el bajo consumo de frutas y vegetales, la circunferencia de la cintura > 90 p y ser fumador pasivo. En el sexo femenino se destaca el sedentarismo. En ambos sexos predominaron los adolescentes con dos o tres señales (masculino 77 [48,4 por ciento] y femenino 71 [48,0 por ciento]). El conjunto de factores contextuales explica hasta el 33 por ciento de la variabilidad en las señales ateroscleróticas tempranas. El árbol de clasificación mostró una mayor frecuencia de adolescentes con señales ateroescleróticas tempranas para la percepción de la situación económica regular o mala y para el nivel educacional mayor de secundaria básica. Conclusiones: Los factores contextuales influyen en la presencia de señales ateroscleróticas tempranas en adolescentes aparentemente sanos, pero explican parcialmente sus variabilidades(AU)

Introduction: The exploration and identification of the contextual factors of the atherosclerotic process from an early age present a knowledge gap in terms of mechanisms and causes. In primary health care, there are the conditions required for the identification of adolescents with atherogenic risk factors and in which it is easier to understand the context of the disease. Objective: Determine the influence of contextual factors on the presence of early atherosclerotic signals in apparently healthy adolescents. Methods: Descriptive cross-sectional study. Descriptive statistics were used. Analysis of canonical correlations was applied and decision trees were elaborated. Results: The atherosclerotic risk factors that predominated for both sexes were low consumption of fruits and vegetables, waist circumference > 90 p and being a passive smoker. In the female sex, a sedentary lifestyle stands out. In both sexes, adolescents with two or three signs predominated (male 77 [48.4percent] and female 71 [48.0percent]). The set of contextual factors explains up to 33percent of the variability in early atherosclerotic signals. The classification tree showed a higher frequency of adolescents with early atherosclerotic signals for the perception of the regular or bad economic situation and for the higher educational level of basic secondary school. Conclusions: Contextual factors influence the presence of early atherosclerotic signals in apparently healthy adolescents, but partially explain their variabilities(AU)

Contextual Narratives Associated With Immunization Services During COVID-19 Disease Outbreak in Chennai, Tamil Nadu

Background: Essential health services including immunization were significantly impacted due to COVID-19 with devastating outcomes in low- and middle-income countries (LMIC). The disruption in immunization services due to global pandemic and measures undertaken at regional levels to overcome need to be studied as pandemic preparedness strategy. Objective: To document the contextual narratives related to immunization services during the Covid-19 disease outbreakby interviewing qualified paediatricians in the field practice area of private tertiary care teaching medical college Methodology: In-depth phone-based interviews were conducted with paediatricians in diverse settings during November 2020 to March 2021. Reflexive thematic analysis was performed, major themes identi-fied, and case studies documented. Results: Paediatricians shared rich experiences related to immunization services impacted due to COVID-19 especially during the earlier months due to imposition of lockdowns leading to discontinua-tion, disruption of services, decrease in volume of immunizations, modest transition to telehealth ser-vice delivery, facility-level changes brought in to ensure immunization services and capacity building measures for upskilling. Conclusions: Contextual narratives revealed in this study provide rich narrative about the disruption of immunization services due to COVID-19. These findings need to be understood and leveraged to be fu-ture ready and prevent further disruptions by identifying and scaling up key solutions piloted in this study.

Complexity theory in the management of patients with pain

Nonlinear systems are not susceptible to being investigated with reductionist methods. In this sense, complexity theory offers an alternative approach to quantify the importance of contextual factors (CFs) in the patient with pain. The result of the positive (placebo) or negative (nocebo) use of CFs in the therapeutic setting could be responsible for a large part of a non-specific component of the efficacy of the treatment, directly affecting the quality of the results related to the patient's health (for example, pain, disability, or satisfaction). In recent years, understanding of the value of these effects has increased. Despite growing interest, knowledge, and awareness of them is currently limited and heterogeneous among health professionals, reducing their translational value in the field of health.Keywords: complexity, contextual factors, pain, health professionals, placebo, nocebo.

Los sistemas no lineales no son susceptibles de ser investigados con métodos reduccionistas. En este sentido, la teoría de la complejidad ofrece un enfoque alternativo para cuantificar la importancia de los factores contextuales (FCs) en el paciente con dolor. El resultado del uso positivo (placebo) o negativo (nocebo) de FCs en el tratamiento podría ser responsable de gran parte de un componente no específico de la eficacia del tratamiento, afectando directamente la calidad de los resultados relacionados con la salud del paciente (por ejemplo, dolor, funcionalidad o satisfacción).En los últimos años se ha incrementado la comprensión del valor de estos efectos. A pesar del creciente interés, el conocimiento y la conciencia de ellos es actualmente limitado y heterogéneo entre profesionales de la salud, lo que reduce su valor traslacional en el campo de la salud.Palabras clave: complejidad; factores contextuales; profesionales de la salud; dolor; placebo; nocebo.

Análise temporal dos gols em uma competição estadual e a relação do primeiro gol com o resultado final da partida / Time analysis of goals in a state competition and the relationship of the first goal with the final result of the match

O estudo teve como objetivo analisar a incidência temporal de gols em uma competição estadual e a relação do primeiro gol com o resultado final da partida em diferentes categorias. Foram analisadas 526 partidas das categorias sub-15, sub-17, sub-20 e profissional, de três competições estaduais de futebol do ano de 2018, realizadas no estado do Rio de Janeiro. A coleta dos dados foi feita a partir do site da Federação de Futebol do Estado do Rio de Janeiro. Foi realizada análise descritiva (média e desvio padrão) e o teste de Shapiro-Wilk para verificar a distribuição dos dados. Na comparação dos gols por intervalo de tempo, foram realizados os testes de Kruskal Wallis (distribuição não normal) e Anova (distribuição normal). Na relação do primeiro gol com o resultado final da partida, foi realizado o teste de Friedman para identificar a existência de diferença estatisticamente significativa entre os resultados da partida e o teste de Wilcoxon para verificar onde houve diferença. O valor de significância adotado foi de p<0,05. No estudo observou-se não haver diferenças significativas na incidência de gols entre os intervalos de tempo. Já na relação do primeiro gol com o resultado final da partida, foram encontradas diferenças significativas (p< 0,001) para todas as categorias na comparação entre vitória e derrota e na comparação entre vitória e empate. Neste estudo, foi possível observar como marcar o primeiro gol pode aumentar a probabilidade de uma equipe alcançar a vitória. (AU)

The study aimed to analyze the temporal incidence of goals in a state competition and the relationship of the opening goal with final match scores in different age/competitive levels. We analyzed 526 matches from the under-15, under-17, under-20 and professional levels from three state soccer tournaments in 2018, held in the state of Rio de Janeiro, were analyzed. Data was obtained through the website of the Rio de Janeiro State Soccer Federation. Descriptive analysis (means and standard deviation) and the Shapiro-Wilk normality test were performed. The Kruskal Wallis (non-parametric data) and ANOVA (parametric data) tests were performed to compare goals according to time interval. The association between the opening goal and the final match score was verified using the Friedman test. The Wilcoxon test was used for pairwise comparisons. The significance level was set at p <0.05. No significant differences between the time intervals were observed regarding the incidence of goals. With respect to the association between the opening goal and the final match score, significant differences were found (p <0.001) for all age levels in the comparison between wins and losses and in the comparison between wins and draws. It was possible to infer that scoring the opening goal may increase a team's probability of winning the match. (AU)

Health inequalities among homeless adolescents / Desigualdades em saúde de adolescentes em situação de rua / Desigualdades en salud de adolescentes en situación de calle

Abstract Objective: highlight health inequalities of homeless adolescents based on the conceptual framework of social determinants of health. Method: this is a convergent parallel mixed-methods study. The population consisted of adolescents who are homeless, with purposeful sampling and data saturation. Quantitative data were obtained with a questionnaire and qualitative data through semi-structured interviews. Results: 19 homeless adolescents participated in the study, 13 (68.4%) aged 16 to 19 years; 11 (57.9%) were male, 3 (15.8%) were female, and 5 (26.3%) were transgender adolescents. Participants experienced different levels of exposure and vulnerabilities to conditions that affect health and were directly related to intermediate determinants of health. Conclusion: this study provides an understanding of the inequalities related to the health of homeless adolescents and shows evidence that supports strategies to promote equity and dignity in health care.

Resumo Objetivo: evidenciar as desigualdades em saúde de adolescentes em situação de rua com base no marco conceitual dos determinantes sociais em saúde. Método: pesquisa de métodos mistos com abordagem convergente paralela. A população foi composta por adolescentes em situação de rua, cuja amostra foi intencional com saturação dos dados. Os dados quantitativos foram obtidos por meio de questionário; e os qualitativos, por meio de entrevista semiestruturada. Resultados: participaram do estudo 19 adolescentes em situação de rua, sendo 13 (68,4%) com idade entre 16 e 19 anos; 11 (57,9%) do gênero masculino, três (15,8%) do gênero feminino e cinco (26,3%) adolescentes trans. Os participantes experimentam diferenças na exposição e vulnerabilidade a condições que comprometem a saúde e que estão diretamente relacionadas aos determinantes intermediários de saúde. Conclusão: o estudo permitiu compreender as desigualdades relativas à saúde de adolescentes em situação de rua e reuniu evidências para estratégias que promovam equidade e dignidade no cuidado à saúde.

Resumen Objetivo: evidenciar las desigualdades en salud de adolescentes que viven en situación de calle con base en el marco conceptual de los determinantes sociales en salud. Método: investigación de métodos mixtos con enfoque convergente paralelo. La población estuvo formada por adolescentes en situación de calle, cuya muestra fue intencional con saturación de los datos. Los datos cuantitativos se obtuvieron por medio de un cuestionario; y los cualitativos, mediante entrevista semiestructurada. Resultados: participaron en el estudio 19 adolescentes en situación de calle, de los cuales 13 (68,4%) con edades entre 16 y 19 años; 11 (57,9%) eran del sexo masculino, tres (15,8%) del sexo femenino y cinco (26,3%), adolescentes trans. Los participantes experimentan diferencias en la exposición y vulnerabilidad a las condiciones que comprometen la salud y que están directamente relacionadas con los determinantes intermedios de la salud. Conclusión: el estudio permitió comprender las desigualdades relativas a la salud de adolescentes en situación de calle y reunió evidencias para estrategias que promuevan la equidad y la dignidad en el cuidado a la salud.

Analysis of goal scoring patterns and match outcome during the Intercontinental Beach Soccer Cup Dubai 2019

Abstract Aim: To characterize the goal-scoring patterns and investigate the goal process on match outcome during the Intercontinental Beach Soccer Cup Dubai 2019. Methods: A set of 35 goal-scoring patterns were grouped into nine macro-categories: Match-period, Court-zone, Set-play, Open-play, Touching by players before the goal, Offensive method, Goalkeeper-line, Number of passes before the goal, and Ball trajectory. Match outcome in regular time was considered the matches resulting in a loss (n=16), draw (n=8), or win (n=16). The offensive sequences that resulted in the goal were analyzed in all 20 matches during the competition (n=138 goals). Results: The most goals were scored in Open-play (69%), during the 2nd and 3rd periods (36% for each), near to goal (Zone 4; 50%), preceded by 1-touch (67%) and 0-pass (29%), using positional attack (46%), without goalkeeper-line (68%), and with high-ball trajectory (51%). In addition, won matches presented a higher number of goals in Zone 4, 1-touch, Counterattack, 4v4 goal-successful, Receiving pass, Sand-touch, and High-ball compared to draw and loss matches (p<0.001−0.03; Effect Size [ES]=1.24−2.58, large). Conclusion: In summary, winning teams scored their goals mainly in open-play situations and without a goalkeeper-line, using counterattacks to achieve zones near the opponent's goals, and implementing a direct offensive style. In addition, goals scored were usually preceded by 1-touch, both through high-ball and sand-touch ball trajectory. Coaches and practitioners may consider these goal processes to train prescription and deep understanding of the process to goal in elite Beach soccer.

Perception of discrimination against immigrants compared to Chilean-born and its relationship with access to services and health outcomes / Percepción de discriminación en inmigrantes comparados a nacidos en Chile y su relación con acceso a servicios y resultados de salud

ABSTRACT OBJECTIVES Compare self-perceived discrimination between immigrants and locals in Chile and analyze the relationship between immigration and perceived discrimination and immigration, discrimination and health outcomes, adjusting for sociodemographic characteristics and social capital. METHODS Cross-sectional study, using population-based survey (CASEN2017). We selected 2,409 immigrants (representative of N = 291,270) and 67,857 locals (representative of N = 5,438,036) over 18 years of age surveyed. We estimated logistic regression models, considering the complex sample, with discrimination, self-rated health, medical treatment, healthcare system membership, complementary health insurance, medical consultation and problems when consulting as dependent variables, immigration and discrimination as main exposure variables, and social capital and sociodemographic variables as covariates of the models. RESULTS Immigrants were more likely to perceive discrimination in general compared to locals (OR = 2.31; 95%CI: 1.9-2.9). However, this does not occur for all specific reasons for discrimination; skin color and physical appearance were the most frequent causes of discrimination in immigrants. The interaction between immigration and discrimination was significantly related to worse self-rated health outcomes and treatment for pathologies, disfavoring discrimination against immigrants. In both locals and immigrants, discrimination was not associated with health care access outcomes, except for problems during consultation in locals (OR = 1.61; 95%CI 1.4-1.8). CONCLUSIONS In Chile, experiences of discrimination are intertwined with other forms of rejection and social exclusion, so it is urgent to raise awareness among the population to prevent these discriminatory practices, especially in health care and daily use places. It is essential to address discrimination in order to have an impact on intermediate variables and health outcomes. The extension of the results to the entire immigrant population could be very useful to deepen the problem and improve the estimates made.

RESUMEN OBJETIVOS Comparar la autopercepción de discriminación entre inmigrantes y locales en Chile y analizar la relación entre inmigración y discriminación percibida e inmigración, discriminación y resultados de salud, ajustando por características sociodemográficas y capital social. MÉTODOS Estudio transversal, utilizando encuesta poblacional (CASEN2017). Se seleccionaron 2.409 inmigrantes (representativos de N = 291.270) y 67.857 locales (representativos de N = 5.438.036) mayores de 18 años encuestados. Se estimaron modelos de regresión logística, considerando la muestra compleja, con discriminación, salud autoevaluada, tratamiento médico, pertenencia al sistema de salud, seguros complementarios de salud, consulta médica y problemas al consultar como variables dependientes, inmigración y discriminación como variables de exposición principal, y capital social y variables sociodemográficas como covariables de los modelos. RESULTADOS Inmigrantes tuvieron mayor posibilidad de percibir discriminación en general comparado con locales (OR = 2,31; IC95% 1,9-2,9). Sin embargo, esto no ocurre para todos los motivos específicos de discriminación; color de piel y apariencia física fueron las causas de discriminación más frecuentes en inmigrantes. La interacción entre inmigración y discriminación se relacionó significativamente con peores resultados de salud autoevaluada y tratamiento por patologías, en desfavor de los inmigrantes discriminados. Tanto en locales como en inmigrantes la discriminación no se asoció con resultados de acceso a atención en salud, excepto problemas durante la consulta en locales (OR = 1,61; IC95% 1,4-1,8). CONCLUSIONES En Chile, las experiencias de discriminación se entrelazan con otras formas de rechazo y exclusión social, por lo cual es urgente concientizar a la población para prevenir estas prácticas discriminatorias, sobre todo en la atención en salud y lugares de uso cotidiano. Abordar la discriminación es indispensable para lograr impactar en variables intermedias y resultados de salud. La extensión de los resultados a toda la población inmigrante podría ser de amplia utilidad para profundizar la problemática y mejorar las estimaciones realizadas.

Provincial differentials of the effect of internal migration on teenage fertility in South Africa

This study investigated the association between internal migration and teenage fertility in South Africa. Data were from the 2007 and 2016 South African community surveys, N2007= 89800 and N2016=239733, age range 12 to 19, black teenagers= 81.5% and 89.4%, respectively. Results showed that between 2007 and 2016 internal migration levels decreased by 2% nationally, but increased for Gauteng, Western Cape and KwaZulu Natal provinces. Teenage fertility levels decreased in all provinces except the Northern Cape in the study period. In both years teenage fertility was observed at higher levels among girls that were older, heads of households, and who were in secondary schooling. Random-intercept multilevel binary logistic regression revealed that the risk of teenage fertility differed between more rural and urban provinces. In provinces that were predominantly rural the risk of teenage pregnancy increased as community-levels of internal migration increased while the risk decreased as internal migration increased in provinces that were predominantly urban. Findings suggest that the effects of internal migration on teenage pregnancy are largely dependent on the local context making it necessary to create interventions that are context-specific at sub-national levels.

Contextual factors in premature non-communicable disease mortality in selected African countries within the sustainable development goals framework: the implication of voice and accountability

Sustainable Development Goal number 3, target 4 (SDG 3.4), seeks a 30% reduction in premature Non-Communicable Diseases (NCDs) mortality from 2015 levels by 2030. Africa United Nations (UN) Member States continue to experience increasing NCD mortality significantly, with the highest proportion of diabetes mortality among the working-age group. Past efforts to address this burden have been centered primarily on individual risk modifications evident by the NCDs Cluster Program at the World Health Organization (WHO) Africa Regional Office. To achieve a progressive reduction, a comprehensive premature NCD reduction approach which includes a consideration of contexts within which premature NCD, such diabetes mortality arises is necessary. The aim was to examine the relationship between contextual factors and diabetes-related deaths as premature NCD mortality and to enable an improved contextualized evidence-based approach to premature NCD mortality reduction. Country-level data was retrieved for post SDG initiative years (2016-2019) from multiple publicly available data sources for 32 selected Africa UN Member States in the International Diabetes Federation (IDF) East and West Africa Region. Multiple linear regression was employed to examine the relationship between diabetes-related deaths in individuals 20-79 years and contextual factors identified within the SDG framework. Weighted data analysis showed that voice and accountability as a contextual factor explained approximately 47% variability in diabetes-related deaths across the selected Africa UN Member Sates in IDF East and West Region (n=32). Civil society engagement is vital to develop effective premature NCD mortality reduction policies, and strategies and stakeholders' accountabilities are necessary to ensure adherence to obligations.

Factores contextuales, familia y factores de riesgo y enfermedades consecuentes de la aterosclerosis / Contextual, family factors and risk factors and consequential diseases of atherosclerosis

Introducción: Se realizó una compilación de investigaciones que abordan el tema de la influencia de los factores contextuales en familias con factores de riesgo y enfermedades consecuentes de la aterosclerosis. Objetivo: Mostrar la influencia de los factores contextuales en familias con factores de riesgo y enfermedades consecuentes de la aterosclerosis. Métodos: Se analizaron algunas investigaciones realizadas en el periodo 2012-2018, se seleccionaron cuatro artículos y cuatro tesis. Se analizó la arterosclerosis con un enfoque social en donde el objeto de investigación fueron la familia y el contexto en que ella vive y se desarrolla, se estimó la contribución relativa de dichos espacios sobre la salud individual y familiar. Resultados: Se identificaron y caracterizaron subpoblaciones con niveles más altos de concentración de la carga de morbilidad y con perfiles de riesgo propio. El contexto influye sobre la salud individual. El patrón de asociaciones entre ciertos factores individuales y las enfermedades consecuentes de la aterosclerosis cambia de un policlínico a otro. El análisis de la correlación canónica entre las variables contextuales y los factores de riesgo permite explicar la variabilidad en los factores de riesgos y enfermedades consecuentes. Conclusiones: El análisis contextual de la situación de salud permitirá continuar el perfeccionamiento de las soluciones diseñadas para enfrentar los problemas de salud, eliminado o disminuyendo las causas que le dieron origen, desde sus raíces, con mayores posibilidades de influir, tanto en el individuo como en la familia y la comunidad, con acciones adecuadas para cada contexto(AU)

Introduction: A compilation of researches was carried out that addresses the issue of the influence of contextual factors in families with risk factors and diseases consequential to atherosclerosis. Objective: Show the influence of contextual factors in families with risk factors and diseases consequential to atherosclerosis. Methods: Some researches carried out in the period 2012-2018 were analyzed; four articles and four theses were selected. Atherosclerosis was analyzed with a social approach where the object of research was the family and the context in which it lives and develops. The relative contribution of these spaces on individual and family health was estimated. Results: Sub-populations with higher levels of concentration of the disease burden and with their own risk profiles were identified and characterized. Context influences individual health. The pattern of associations between certain individual factors and the consequential diseases of atherosclerosis changes from one polyclinic to another. The analysis of the canonical correlation between contextual variables and risk factors allows to explain the variability in risk factors and consequential diseases. Conclusions: The contextual analysis of the health situation will allow to continue the improvement of the solutions designed to face the health problems, eliminating or reducing the causes that gave rise to it, from its roots, with greater possibilities of influencing, both in the individual and in the family and the community, with appropriate actions for each context(AU)

Una verdad con muchos interrogantes: preguntas incómodas sobre las cifras oficiales del conflicto armado en Colombia / A Truth with Many Questions: Uneasy Questions about the Official Figures on the Armed Conflict in Colombia

Resumen Las cifras suelen revestirse con un manto de veracidad y contundencia que pocos replican porque se piensa que éstas son un reflejo de la realidad y que los datos son meras agregaciones de hechos constatables. Este artículo hace preguntas incómodas a cuatro cifras oficiales del conflicto armado y revela sus implicaciones en las luchas por la verdad. Su énfasis se pone en cómo los contextos, los mediadores y las decisiones metodológicas interfieren en la producción de datos y cómo la presentación de estos condiciona el debate público por las responsabilidades y las víctimas del conflicto armado.

Abstract Figures are often cloaked in a mantle of veracity and forcefulness, which few people replicate because they are thought to be a reflection of reality and the data are mere aggregations of verifiable facts. This article asks uncomfortable questions of four official figures of the armed conflict, and it reveals their implications for struggles for truth. Its emphasis is on how contexts, mediators, and methodological decisions interfere with the production of data and how the presentation of these data constrains the public debate over responsibilities and victims of the armed conflict.

Governança e capacidade estatal frente à COVID-19 na Alemanha e na Espanha: respostas nacionais e sistemas de saúde em perspectiva comparada / Governance and state capacities against COVID-19 in Germany and Spain: national responses and health systems from a comparative perspective

Resumo O objetivo foi analisar, em perspectiva comparada, estratégias e ações políticas adotadas em resposta à pandemia de COVID-19 na Alemanha e na Espanha em 2020. Baseando-se no institucionalismo histórico, o foco foi a institucionalidade da atuação governamental em cinco dimensões de atuação. Os resultados evidenciaram diferentes capacidades estatais na coordenação, implementação e efetividade de estratégias. Pontos fortes da gestão e governança da crise estão relacionados ao reconhecimento da sua gravidade e capacidade de negociação; capacidade de produção nacional de insumos e equipamentos; e amplo direcionamento de recursos fiscais e financeiros do governo central para as áreas sanitária, social e econômica. Esses aspectos variaram entre os casos, atuando como diferencial relevante na resposta governamental. Outros diferenciais foram: estrutura do sistema de saúde; disponibilidade de trabalhadores; e sistema nacional de ciência e tecnologia, destacando a importância de investimentos de médio e longo prazo.

Abstract This study aimed to analyze comparatively strategies and political actions adopted in response to the COVID-19 pandemic in Germany and Spain in 2020. Based on historical institutionalism, we focused on the institutionality of government action in five work dimensions. The results showed different state capacities in coordination, implementation, and effectiveness of strategies. Crisis management and governance strengths are related to recognizing its severity and negotiation skills; national production capacity of supplies and equipment; and broad targeting of fiscal and financial resources from central government to health, social, and economic areas. These aspects varied between cases, acting as a relevant differential in governmental response. Other differentials were health system's structure; availability of workers; and national science and technology system, highlighting the importance of medium and long-term investments.

Multilevel analysis of birthplace effect on the proportion of C-Section in Colombia" / Análisis multinivel del efecto del lugar de nacimiento en la proporción de partos por cesárea en Colombia

Abstract Objectives: To determine the general contextual effect of the department in the variation of Cesarean section in Colombia in 2016, and their individual and contextual related factors. Methods: Cross-sectional study based on a birth cohort. We used the birth certificate database from January 1 to December 31, 2016. Three multilevel logistic models were constructed. Pregnant women were set at the first level and department at the second level. We fitted a null multilevel model followed by two multiple models, including individual and individual and department variables, respectively. Results: The overall prevalence of C-section was 45.5% (95% CI: 45.4-45.6), ranged from 5 to 76%. The variance partition coefficient was 15%. Individual factors did not explain the general contextual effect. However, the region to which these departments belong explained 71% of the variance. The Caribbean region was positively associated with C-section compared to the Andean region (OR:3.88, 95% CI: 2.65-5.67). Conclusions: Multilevel analysis of individual heterogeneity and discriminatory accuracy showed that the department plays an important role in the variation of C-sections in Colombia. Our results suggest that the proportional universalism approach should be applied to reduce the proportion of C-Section, focusing on departments with the highest risk and on the Caribbean and Insular region.

Resumen Objetivos: Determinar el efecto contextual de los límites político administrativo de los departamentos, en la posibilidad individual de cesárea en el año 2016 y, las características individuales y contextuales asociadas a la misma. Métodos: Estudio transversal de una cohorte de nacimientos. Se realizó un análisis multinivel utilizando como fuente la base de datos de los certificados de nacimientos de Colombia desde el 1 de enero al 31 de diciembre de 2016. Se elaboraron tres modelos logísticos multinivel, con las gestantes en el primer nivel y el departamento como segundo nivel. El primer modelo incluyó solo el departamento como efecto aleatorio, seguido de otro con variables individuales y el último incluyó también las variables de contexto. Resultados: La proporción de cesáreas fue de 45.5% (IC 95%: 45.4-45.6), con un rango de 5% al 76%. El coeficiente de partición de varianza fue de 15%, indicando la existencia de una considerable desigualdad geográfica en la posibilidad del parto por cesárea. La región a la que pertenecen los departamentos explicó 71 % de la varianza entre departamentos. En particular, la región Caribe se asoció de manera positiva con la posibilidad de cesáreas comparado con la región Andina (OR:3.88, IC 95%: 2.65-5.67). Conclusiones: El análisis multinivel de la heterogeneidad individual mostró que el departamento juega un papel importante en la posibilidad de partos por cesáreas. Nuestros resultados sugieren que intervenciones con enfoque de universalismo proporcional son necesarias para reducir el parto por cesárea con énfasis en los departamentos de mayor riesgo y en la región Caribe e Insular

Fatores Influenciantes na Excelência de Cientistas Brasileiros / Influential Factors in the Excellence of Brazilian Scientists / Factores Influyentes en la Excelencia de los Científicos Brasileños

Este estudo objetivou investigar as variáveis pessoais e os fatores contextuais relacionados com a excelência de pesquisadores de ambos os gêneros e de diferentes áreas do conhecimento. A amostra foi constituída por 109 pesquisadores, bolsistas de produtividade do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), que trabalham em instituições de ensino superior de várias regiões do Brasil. Utilizou-se o Questionário do Perfil de Excelência online formado por perguntas semi-abertas relacionadas a recursos pessoais, fatores acadêmicos e de fatores contextuais. Os resultados obtidos apontam para diferenças estatisticamente significantes de frequência de respostas entre os gêneros quanto à paixão pelo trabalho para enfrentar novos projetos de pesquisa, uso do suporte social, utilização de empregados para conciliar a vida pessoal com a profissional, na ocupação do tempo livre na realização de viagens e nas atividades com a família. Os resultados sugerem a natureza multivariada do fenômeno da excelência científica, convergindo na sua manifestação fatores pessoais e contextuais. Ambos os fatores merecem ser considerados quando se procura promover a sua realização profissional e produtividade. (AU)

This study aimed to investigate personal variables and contextual factors related to the excellence of researchers of both genders and different areas of knowledge. The sample consisted of 109 researchers, National Scientific and Technological Development Council (CNPq) productivity fellows, who work in higher education institutions in various regions of Brazil. The Online Excellence Profile Questionnaire was used. This questionnaire consists of semi-open questions about personal resources, academic factors and contextual factors. The results obtained indicate statistically significant difference frequency of answers between genders regarding the passion for work face new research projects, use of social support, use of employees to reconcile the personal life of the professional, in the occupation of free time with travel and in family activities. The results suggest a multivariate nature of the phenomenon of scientific excellence, converging in its manifestation personal and contextual factors. Both factors deserve to be considered when seeking to promote their professional fulfillment and productivity. (AU)

Este estudio tuvo como objetivo investigar las variables personales y los factores contextuales relacionados con la excelencia de los investigadores de ambos sexos y de diferentes áreas del conocimiento. La muestra consistió en 109 investigadores, becarios de productividad del Consejo Nacional de Desarrollo Científico y Tecnológico (CNPq), que trabajan en instituciones de educación superior en varias regiones de Brasil. Se utilizó el cuestionario de perfil de excelencia en línea. Este cuestionario consta de preguntas semiabiertas sobre recursos personales, factores académicos y factores contextuales. Los resultados obtenidos apuntan a diferencias estadísticamente significativas en la frecuencia de respuestas entre los géneros con respecto a la pasión por el trabajo para hacer frente a nuevos proyectos de investigación, el uso del apoyo social, el uso de empleados para conciliar la vida personal del profesional, la ocupación del tiempo libre para viajar y actividades familiares. Los resultados sugieren la naturaleza multivariante del fenómeno de la excelencia científica, convergiendo en su manifestación factores personales y contextuales. Ambos factores merecen ser considerados a la hora de promover su realización y productividad profesional. (AU)