Male-On-Male Child and Adolescent Sexual Abuse in the Caribbean Region of Colombia: A Secondary Analysis of Medico-Legal Reports.

Child and adolescent sexual abuse (CSA) is an important global health problem, especially in non-Western low- and middle-income countries. A number of studies have indicated that, in Latin American countries, male CSA is phenomenon of great concern. However, research on this topic is seriously lacking, and more specifically, on male-on-male CSA. We carried out a qualitative and quantitative secondary analysis of 680 cases of alleged male-on-male CSA that occurred between the years 2017 and 2018 in the Caribbean Region of Colombia. We analyzed the contents of forensic interviews with the alleged victims, conducted by professionals working at the Colombian Institute of Legal Medicine and Forensic Sciences. Our findings indicated a high prevalence of cases of alleged male-on-male CSA among young minors. Most of these cases were allegedly perpetrated by offenders known to the victim and involved high levels of violence. Evidence-based and culturally grounded preventative actions, such as training-based programs for teachers and parents among other public health initiatives are needed to address this type of CSA. Further research is also required to gain a more fine-grained understanding of the cultural and social context of CSA in the Caribbean Latin American countries.

Colombian Elders and Their Use of Handheld Digital Devices.

Technological advances in the information and knowledge society have influenced and transformed economic, social, and educational dynamics. Currently there are many digital gaps related to the access to technology, level of digital literacy, and social use. These gaps vary based on the age of the population and become more noticeable among elders. Digital illiteracy leads to the underusing of technological developments of the 21st century, making it difficult to take advantage of all the possibilities that they offer to our society. This study aims to analyze the level of penetration and use of handheld digital devices, especially the cellular phone, among the adult population. This study is based on the 2016 National Survey of Life Quality in Colombia, elaborated by Departamento Administrativo Nacional de Estadística-DANE, specifically on the module of ownership and use of ICT goods. Results of four age groups are compared, which include 32 year olds or under, from ages 33 to 45 years, 46 to 59 years, and over 60 years. The sample consists of 37047 inhabitants of the Colombian territory, grouped by regions (Antioquia, Bogota, Caribbean, Eastern Central, Orinoquia, Amazonia, Pacific, San Andres, and Valle del Cauca). Data have been analyzed by descriptive and inferential statistical procedures, contingency tables analyses, and logistic regression, in order to identify and know the effect of age on the level of penetration and use of handheld digital devices when comparing results in young adults and elderly people. Findings show that young adults use these technologies to a greater proportion when compared to older adults, showing a significant correlation between age and the increase of digital gaps in access and social use of handheld digital devices. Results also make evident that digital divide in Colombia may be associated to the place of residence, as people who live in rural zones are the ones who suffer greater from inequalities.

Interculturality in the formation of health students: A Colombian experience / Interculturalidad en la formación de estudiantes de salud: Una experiencia en Colombia / Interculturalidade na formação de estudantes de saúde: uma experiência na Colombia / Interculturalité dans la formation des étudiants en santé: Une expérience colombienne

Abstract Objective: The purpose of this study was the evaluation of an inter-cultural competence training program among first and sixth semester medical students at a university in Colombia. Materials and methods: This study utilized a quasi-experimental research design to evaluate an intercultural training program among 100 first and sixth semester medical students. Data were collected using the Intercultural Competency Scale and were analyzed using Wilcoxon Signal Range Test for related samples in SPSS version 21. Results: Significant differences were found in the areas of developing cultural sensitivity as well as developing understanding and respect for differences and diversity among first and six semester students in the experimental group. Conclusions: Findings suggest a strong need to incorporate intercultural training into the educational experience of medical students.

Resumen Objetivo: El objetivo de este estudio es evaluar un programa de capacitación en competencias interculturales entre estudiantes de medicina de primer y sexto semestre en una universidad de Colombia. Materiales y métodos: Este estudio utilizó un método de investigación cuasi-experimental para evaluar un programa de capacitación intercultural entre 100 estudiantes de primer y sexto semestre de medicina. Los datos se recolectaron utilizando la Escala de Competencia Intercultural y se analizaron utilizando la Prueba de Rango de Señales de Wilcoxón para muestras relacionadas en SPSS versión 21. Resultados: Se encontraron diferencias significativas en las áreas de desarrollo de la sensibilidad cultural, así como en el desarrollo de la comprensión y el respeto por las diferencias y la diversidad entre los estudiantes de primer y sexto semestre en el grupo experimental. Conclusiónes: Los hallazgos sugieren una fuerte necesidad de incorporar el entrenamiento intercultural en la experiencia educativa de los estudiantes de medicina.

Resumo Objectivo: O objetivo deste estudo é avaliar um programa de formação sobre competencias interculturais de estudantes de medicina do primeiro e sexto semestre numa universidade na Colõmbia. Materiais e métodos: Este estudo utilizou um método quase-experimental de pesquisa para avaliar um programa de formação intercultural entre os 100 caloiros e do sexto semestre de Medicina. Os dados foram recolhidos utilizando a Escala de Competencia Intercultural e foram analisados utilizando o Teste de Sinal de Wilcoxon para amostras em SPSS 21. Resultados: Foram encontradas diferenças significativas nas áreas de desenvolvimento da sensibilidade cultural, bem como o desenvolvimento da compreensáo e respeito pelas diferenças e diversidade entre estudantes caloiros e de sexto semestre do grupo experimental. Conclusões: Os resultados sugerem a necessidade de incorporar a formação em experiencia educacional intercultural na formação de estudantes de Medicina.

Résumé Objectif: L'objectif de cette étude est d'évaluer un programme de formation en compétences interculturelles parmi les étudiants en médecine de premier et sixieme semestre d'une université colombienne. Matériel et méthodes: Une méthode de recherche quasi-expérimentale a été utilisée pour évaluer un programme de formation interculturelle avec 100 étudiants de premier et sixieme semestre de médecine. Les données ont été recueillies a l'aide de l'Échelle de Compétence Interculturelle et analysées a l'aide du test de rangs signés de Wilcoxon pour échantillons appariés avec la version SPSS 21. Résultats: Des différences significatives dans les domaines du développement de la sensibilité culturelle ont été trouvées, ainsi que dans le développement de la compréhension et le respect des différences et de la diversité entre les étudiants du premier et du sixieme semestre du groupe expérimental. Conclusions: Les résultats suggerent l'importante nécessité d'intégrer l'entrainement interculturel dans l'expérience éducative interculturelle des étudiants en médecine.

Portación Nasal de Staphylococcus aureus y su Asociación con Forunculosis a Repetición

Resumen Staphylococcus aureus es una bacteria que coloniza la piel y/o fosas nasales de las personas sanas y produce una amplia gama de infecciones, desde forúnculos hasta las más graves como neumonía o sepsis. La portación nasal de S.aureus parece ser clave en la epidemiologia y la patogenia de la infección. S. aureus se caracteriza por presentar el gen mecA que confiere resistencia a meticilina pudiendo ser sensible a otros antibióticos no betalactámicos. Su virulencia se asocia principalmente a la toxina Leucocidina de Panton Valentine (PVL) una citotoxina que provoca destrucción de los leucocitos y necrosis tisular, lo que a su vez facilita la producción de abscesos. Los objetivos de este estudio fueron, asociar la portación nasal de S. aureus con la forunculosis a repetición, determinar por el método de reacción en cadena de la polimerasa (PCR) los genes que codifican la meticilino resistencia y la toxina PVL. Se estudiaron 128 cepas de S. aureus provenientes de pacientes que estuvieron con o sin tratamiento con antibióticos, y que concurrieron al laboratorio entre 2016 y 2017 con diagnóstico de forunculosis a repetición, de las cuales 74 cepas se aislaron de las lesiones y 54 de sus hisopados nasales. Del total de cepas, se obtuvieron 66,4% de meticilino resistencia y 78,9% presentaron la toxina PVL. Se obtuvo una alta asociación entre la portación nasal de S. aureus de la comunidad con forunculosis a repetición (OR: 5,3 IC95: 1,9 - 14,2%; p = 0,0004< p=0,02; X2)

Abstract Staphylococcus aureus is a bacterium that colonizes the skin and / or nostrils of healthy people and produces a wide range of infections, from forunculosis to the most serious such as pneumonia or sepsis. The nasal carriage of Staphylococcus aureus appear to be key in the epidemiology and pathogenesis of infection. Staphylococcus aureus characterizes by presenting the mecA gene which confers resistance to methicillin and could be sensitive to other non-beta-lactam antibiotics. Its virulence is mainly associated to the Panton-Valentine Leucocidine (PVL) a cytotoxin that causes destruction of the leukocytes and tissue necrosis, which facilitates the abscess production. The objectives of this study were, to associate the nasal carriage of Staphylococcus aureus with recurrent forunculosis, to determine by the polymerase chain reaction method (PCR) the genes encoding methicillin resistance and the toxin PVL. It was studied 128 strains of Staphylococcus aureus from patients with or without antibiotic treatment and went to the laboratory between 2016 and 2017 with recurrent forunculosis, of which 74 strains were isolated from the lesions and 54 from nasal swabs. Of the total strains, 66.4% were methicillin resistance and 78.9% presented PVL toxin. There obtained a high association between the nasal carriage of Staphylococcus aureus of the community with recurrent forunculosis (OR: 5,3 IC95: 1,9 - 14,2%; p = 0,0004< p=0,02; X2).

Clínica psicológica fenomenológica existencial como espaço de resgate do sonho / Existential phenomenological psychological clinic as a possibility of rescue of dreams

A sociedade contemporânea é marcada por uma crise de sentido. Vivemos de forma individualista e competitiva, sem nos preocuparmos uns com os outros e deixando de lado, muitas vezes, o que mais profundamente nos diz respeito: nossa intimidade. Acreditamos que, em boa parte, isso se deva ao lugar que a técnica moderna vem ocupando na vida das pessoas. Sendo a técnica o motor da sociedade, nossa capacidade de sonhar que a ela não se enquadra e que para esta não tem serventia, vem sendo desprezada. Procuramos mostrar com este artigo, por meio de reflexão teórica e pesquisa bibliográfica, a importância da nossa capacidade de sonhar como forma de nos lançarmos para além dos limites que a técnica nos impõe, ou seja, em direção ao outro, a nós mesmos e à nossa felicidade. As modalidades do sonhar aqui abordadas são o desejo, o devaneio poético e a imaginação poética. Nesta direção, apontamos a importância do sonho na prática da clínica fenomenológica existencial.

Contemporary society has been achieved by a crisis in meaning. We have lived in an individualistic and competitive way without caring about each other and, many times, leaving out what most deeply concerns us: our intimacy. We believe that, in large part, this is due to the importance that modern technique has gained into people´s lives. Modern technique, in our conception, is the engine of society. Our capacity to dream, in this context, has been neglected, because it´s not considered important or useful. Based on bibliographical research and theoretical thinking we intend to show through this article the importance of our capacity to dream as a way to put ourselves beyond the limits that technique imposes on us, that is, toward each other, toward ourselves and toward our happiness. The modalities of dream discussed here are desire, poetic reverie and poetic imagination. In this direction, we point out the importance of the dream to clinical practice of existential phenomenology.

Clínica psicológica fenomenológica existencial como espaço de resgate do sonho / Existential phenomenological psychological clinic as a possibility of rescue of dreams

A sociedade contemporânea é marcada por uma crise de sentido. Vivemos de forma individualista e competitiva, sem nos preocuparmos uns com os outros e deixando de lado, muitas vezes, o que mais profundamente nos diz respeito: nossa intimidade. Acreditamos que, em boa parte, isso se deva ao lugar que a técnica moderna vem ocupando na vida das pessoas. Sendo a técnica o motor da sociedade, nossa capacidade de sonhar que a ela não se enquadra e que para esta não tem serventia, vem sendo desprezada. Procuramos mostrar com este artigo, por meio de reflexão teórica e pesquisa bibliográfica, a importância da nossa capacidade de sonhar como forma de nos lançarmos para além dos limites que a técnica nos impõe, ou seja, em direção ao outro, a nós mesmos e à nossa felicidade. As modalidades do sonhar aqui abordadas são o desejo, o devaneio poético e a imaginação poética. Nesta direção, apontamos a importância do sonho na prática da clínica fenomenológica existencial.(AU)

Contemporary society has been achieved by a crisis in meaning. We have lived in an individualistic and competitive way without caring about each other and, many times, leaving out what most deeply concerns us: our intimacy. We believe that, in large part, this is due to the importance that modern technique has gained into people´s lives. Modern technique, in our conception, is the engine of society. Our capacity to dream, in this context, has been neglected, because it´s not considered important or useful. Based on bibliographical research and theoretical thinking we intend to show through this article the importance of our capacity to dream as a way to put ourselves beyond the limits that technique imposes on us, that is, toward each other, toward ourselves and toward our happiness. The modalities of dream discussed here are desire, poetic reverie and poetic imagination. In this direction, we point out the importance of the dream to clinical practice of existential phenomenology.(AU)

Degree of control and delayed intensification of antihyperglycaemic treatment in type 2 diabetes mellitus patients in primary care in Spain.

OBJECTIVES: Primary aim: to determine the degree of control of HbA(1c) at the time of treatment intensification (TI) in T2DM patients. Secondary aims: fasting plasma glucose levels; estimation of the elapsed time between HbA(1c) exceeding 7% and TI; antidiabetic combinations used, % patients with good cardiometabolic control (LDL-c<100mg/dL; SBP<130 and DPB<80mmHg and HbA(1c)<7%). RESEARCH DESIGN AND METHODS: one-cohort, multicenter, retrospective, observational study conducted in Spain. Patients diagnosed with T2DM that had switched from monotherapy to combination antidiabetic therapy were evaluated at baseline and after one year of follow-up. RESULTS: a total of 1202 T2DM patients were analyzed. At the time of TI: mean HbA(1c) 8.1%; median time of uncontrolled disease: 2.0 years. After one-year of TI: significant reduction in mean HbA(1c) (8.1% vs.7.0%, p<0.001) and a mean fasting plasma glucose levels reduction (181.1mg/dL vs.144.1mg/dL, p<0.001) was also observed. The percentage of patients under glycemic control (HbA(1c)<7%) increased from 12.2% to 51.6% (p<0.001). Most common antidiabetic combinations: metformin+sulfonylurea (44.1%) and metformin+thiazolidindione (15.9%). CONCLUSIONS: in the population of T2DM patients analyzed, TI was carried out when HbA(1c) values were above those recommended in clinical guidelines (≤ 7%), with a delay of two years to address the second step of therapy, despite the consensus recommendation of the ADA/EASD of 3 months. TI was shown to be effective since addition of a second antidiabetic drug led to an average reduction of HbA(1c) of approximately 1%. Metformin was the drug most commonly used as monotherapy being the most frequent combination metformin+sulfonylurea.