Methods proposed for monitoring the implementation of evidence-based research: a cross-sectional study.

OBJECTIVES: Evidence-based research (EBR) is the systematic and transparent use of prior research to inform a new study so that it answers questions that matter in a valid, efficient, and accessible manner. This study surveyed experts about existing (e.g., citation analysis) and new methods for monitoring EBR and collected ideas about implementing these methods. STUDY DESIGN AND SETTING: We conducted a cross-sectional study via an online survey between November 2022 and March 2023. Participants were experts from the fields of evidence synthesis and research methodology in health research. Open-ended questions were coded by recurring themes; descriptive statistics were used for quantitative questions. RESULTS: Twenty-eight expert participants suggested that citation analysis should be supplemented with content evaluation (not just what is cited but also in which context), content expert involvement, and assessment of the quality of cited systematic reviews. They also suggested that citation analysis could be facilitated with automation tools. They emphasized that EBR monitoring should be conducted by ethics committees and funding bodies before the research starts. Challenges identified for EBR implementation monitoring were resource constraints and clarity on responsibility for EBR monitoring. CONCLUSION: Ideas proposed in this study for monitoring the implementation of EBR can be used to refine methods and define responsibility but should be further explored in terms of feasibility and acceptability. Different methods may be needed to determine if the use of EBR is improving over time.

The effect of machine learning tools for evidence synthesis on resource use and time-to-completion: protocol for a retrospective pilot study.

BACKGROUND: Machine learning (ML) tools exist that can reduce or replace human activities in repetitive or complex tasks. Yet, ML is underutilized within evidence synthesis, despite the steadily growing rate of primary study publication and the need to periodically update reviews to reflect new evidence. Underutilization may be partially explained by a paucity of evidence on how ML tools can reduce resource use and time-to-completion of reviews. METHODS: This protocol describes how we will answer two research questions using a retrospective study design: Is there a difference in resources used to produce reviews using recommended ML versus not using ML, and is there a difference in time-to-completion? We will also compare recommended ML use to non-recommended ML use that merely adds ML use to existing procedures. We will retrospectively include all reviews conducted at our institute from 1 August 2020, corresponding to the commission of the first review in our institute that used ML. CONCLUSION: The results of this study will allow us to quantitatively estimate the effect of ML adoption on resource use and time-to-completion, providing our organization and others with better information to make high-level organizational decisions about ML.

Developing a tool to assess the skills to perform a health technology assessment.

BACKGROUND: Health technology assessment (HTA) brings together evidence from various disciplines while using explicit methods to assess the value of health technologies. In resource-constrained settings, there is a growing demand to measure and develop specialist skills, including those for HTA, to aid the implementation of Universal Healthcare Coverage. The purpose of this study was twofold: a) to find validated tools for the assessment of the technical capacity to conduct a HTA, and if none were found, to develop a tool, and b) to describe experiences of its pilot. METHODS: First, a mapping review identified tools to assess the skills to conduct a HTA. A medical librarian conducted a comprehensive search in four databases (MEDLINE, Embase, Web of Science, ERIC). Then, incorporating results from the mapping and following an iterative process involving stakeholders and experts, we developed a HTA skills assessment tool. Finally, using an online platform to gather and analyse responses, in collaboration with our institutional partner, we piloted the tool in Ghana, and sought feedback on their experiences. RESULTS: The database search yielded 3871 records; fifteen those were selected based on a priori criteria. These records were published between 2003 and 2018, but none covered all technical skills to conduct a HTA. In the absence of an instrument meeting our needs, we developed a HTA skill assessment tool containing four sections (general information, core and soft skills, and future needs). The tool was designed to be administered to a broad range of individuals who would potentially contribute to the planning, delivery and evaluation of HTA. The tool was piloted with twenty-three individuals who completed the skills assessment and shared their initial impressions of the tool. CONCLUSIONS: To our knowledge, this is the first comprehensive tool enabling the assessment of technical skills to conduct a HTA. This tool allows teams to understand where their individual strengths and weakness lie. The tool is in the early validation phases and further testing is needed. TRIAL REGISTRATION: Not applicable.

Users' experiences with an interactive Evidence to Decision (iEtD) framework: a qualitative analysis.

BACKGROUND: Evidence to Decision (EtD) frameworks bring clarity, structure and transparency to health care decision making. The interactive Evidence to Decision (iEtD) tool, developed in the context of the DECIDE project and published by Epistemonikos, is a stand-alone online solution for producing and using EtD frameworks. Since its development, little is known about how organizations have been using the iEtD tool and what characterizes users' experiences with it. This missing information is necessary for any teams planning future developments of the iEtD tool. METHODS: This study aimed to describe users' experiences with the iEtD and identify main barriers and facilitators related to use. We contacted all users registered in the iEtD via email and invited people who identified themselves as having used the solution to a semi-structured interview. Audio recordings were transcribed, and one researcher conducted a directed content analysis of the interviews guided by a user experience framework. Two researchers checked the content independently for accuracy. RESULTS: Out of 860 people contacted, 81 people replied to our introductory email (response rate 9.4%). Twenty of these had used the tool in a real scenario and were invited to an interview. We interviewed all eight users that accepted this invitation (from six countries, four continents). 'Guideline development' was the iEtD use scenario they most commonly identified. Most participants reported an overall positive experience, without major difficulties navigating or using the different sections. They reported having used most of the EtD framework criteria. Participants reported tailoring their frameworks, for instance by adding or deleting criteria, translating to another language, or rewording headings. Several people preferred to produce a Word version rather than working online, due to the burden of completing the framework, or lack of experience with the tool. Some reported difficulties working with the exportable formats, as they needed considerable editing. CONCLUSION: A very limited number of guideline developers have used the iEtD tool published by Epistemonikos since its development. Although users' general experiences are positive, our work has identified some aspects of the tool that need improvement. Our findings could be also applied to development or improvement of other solutions for producing or using EtD frameworks.

Analysis of reporting completeness in exercise cancer trials: a systematic review.

BACKGROUND: Exercise is an effective therapeutic intervention for cancer survivors. Concerns about the completeness of reporting of exercise interventions have been raised in the literature, but without any formal analysis. This study aimed to evaluate the completeness of reporting of exercise interventions for cancer survivors in a large sample of randomized clinical trials (RCTs). METHODS: We developed a pre-defined protocol. We searched MEDLINE, EMBASE, and CENTRAL for exercise trials in oncology between 2010 and 2017. Pairs of independent researchers screened the records, extracted study characteristics, and assessed 16 items on the TIDieR checklist (i.e., the 12 items, with item 5 divided into two and item 8 divided into four). For each of these items, the percentage of interventions in the included studies that reported the item was calculated. RESULTS: We included 131 RCTs reporting 138 interventions in the analysis. Breast cancer was the most common type of cancer (69, 50%), and aerobic exercise was the most studied exercise modality (43, 30%) followed by combined aerobic and resistance training (40, 28%). Completeness of reporting ranged from 42 to 96% among the TIDieR items; none of the items was fully reported. 'Intervention length' was the most reported item across interventions (133, 96%), followed by 'rationale' (131, 95%), whereas 'provider' (58, 42%) and 'how well (planned)' (63, 46%) were the two least reported items. Half of the TIDieR items were completely reported in 50 to 70% of the interventions, and only four items were reported in more than 80% of the interventions (Items 2 and 8a to c). The seven items deemed to be core for replication (Items 3 to 9) exhibited a mean reporting of 71%, ranging from 42 to 96%. CONCLUSION: Exercise training interventions for cancer survivors are incompletely reported across RCTs published between 2010 and 2017. The reporting of information about the provider, materials, and modifications require urgent improvements. Stronger reporting will enhance usability of trial reports by both healthcare providers and survivors, and will help to reduce research waste.

Creencias y conocimientos relacionados a la práctica del autoexamen de mama en mujeres universitarias de Colombia: Un estudio descriptivo / Beliefs and knowledge related to the practice of Breast self-examination in Colombian university women: A descriptive study

RESUMEN Objetivo Estudios epidemiológicos han identificado el autoexamen de mama (AEM) y el conocimiento de los factores de riesgo como estrategias para la detección precoz del cáncer de mama. El objetivo de este estudio es determinar la prevalencia de la práctica del AEM e identificar los conocimientos de autocuidado y creencias relacionados al AEM en mujeres de Bogotá, Colombia. Métodos Estudio descriptivo y transversal, en 628 mujeres universitarias entre 18 y 30 años de edad, de Bogotá, Colombia. La práctica del AEM, el autocuidado y las creencias se recogieron por medio de una encuesta estructurada. Se calcularon prevalencias y se establecieron asociaciones mediante la construcción de modelos de regresión logística binaria. Resultados De la población evaluada, el 11,3% de las mujeres acusaron practicarse el AEM mensualmente en los últimos 12 meses. Tras ajustar por edad y estrato socioeconómico se observó que las participantes que recibieron información previa acerca de la detección temprana del cáncer de seno OR 2,76 (IC95% 1,29-5,91), que tenían conocimientos de la enfermedad OR 3,24 (IC95% 1,76-5,97) y que reportaron conocer el examen de mamografía OR 2,04 (IC95% 1,13-3,68); se asociaron como variables con la realización del AEM. Conclusión La práctica del AEM en la población estudiada fue baja y el conocimiento sobre los factores de riesgo del cáncer se asociaron positivamente con la práctica del AEM. Estos datos podrían utilizarse para ofrecer programas de intervención educativa entre las mujeres universitarias de Colombia.

ABSTRACT Objective Epidemiological evidences have identified both Breast-Self Examination (BSE) and the awareness about risk factors as early detection strategies for breast cancer. The aim of this study was to determine the prevalence of BSE and identify self-care knowledge and beliefs about BSE in women from Bogota, Colombia. Methods Cross-sectional study in 628 between 18 and 30 years old from Bogota, Colombia. BSE prevalence, self-care and beliefs were collected by structured survey. We estimated prevalence rates and association measures were calculated through logistic regression models. Results The 11.3% of the participants practiced BSE monthly in the last 12 months. After adjustments for age and socioeconomic status, participants whose received previous advice about early detection OR 2.76 (CI95% 1.29-5.91), had previous knowledge about the disease OR 3.24 (CI95% 1.76-5.97) and that reported to know about mammography OR 2.04 (CI95% 1.13-3.68), were associated with the practice of BSE. Conclusion The practice of BSE was low in the studied population and the levels of knowledge about risk factors were positively associated with the practice of BSE. These data could serve to offer educative intervention programs among young women from Colombia.

The insulin-like growth factor system is modulated by exercise in breast cancer survivors: a systematic review and meta-analysis.

BACKGROUND: Insulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an effective intervention in improving cancer-related outcomes and survival, although its effects on IGF´s are not well understood. This meta-analysis aimed to determine the effects of exercise in modulating IGF´s system in breast cancer survivors. METHODS: Databases of PuMed, EMBASE, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, SPORTDiscus, LILACS and Scopus were systematically searched up to November 2014. Effect estimates were calculated through a random-effects model of meta-analysis according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I (2) test. Risk of bias and methodological quality were evaluated using the PEDro score. RESULTS: Five randomized controlled trials (n = 235) were included. Most women were post-menopausal. High-quality and low risk of bias were found (mean PEDro score = 6.2 ± 1). Exercise resulted in significant improvements on IGF-I, IGF-II, IGFBP-I, IGFBP-3, Insulin and Insulin resistance (P < 0.05). Non-significant differences were found for Glucose. Aerobic exercise improved IGF-I, IGFBP-3 and Insulin. No evidence of publication bias was detected by Egger´s test (p = 0.12). CONCLUSIONS: Exercise improved IGF´s in breast cancer survivors. These findings provide novel insight regarding the molecular effects of exercise on tumoral microenvironment, apoptosis and survival in breast cancer survivors.

[Not Available]. / Nivel y estado nutricional en niños y adolescentes de Bogotá, Colombia. Estudio FUPRECOL.

Objetivos: los objetivos de este estudio fueron analizar el nivel nutricional en una población de niños y adolescentes colombianos y determinar la posible relación entre el nivel nutricional y el estado nutricional según el índice de masa corporal (IMC) y la circunferencia de cintura (CC).Material y métodos: estudio transversal en 6.383 niños y adolescentes de entre 9 y 17,9 años de edad, de Bogotá, Colombia. Se aplicó de manera autodiligenciada el cuestionario Krece Plus validado en el estudio enKid como indicador del nivel nutricional con las categorías alto (test ≥ 9), medio (test 6-8) y bajo (test ≤ 5). Se tomaron medidas de peso, talla, CC, y se calculó el IMC como marcadores del estado nutricional.Resultados: de la población general, el 57,9% eran chicas (promedio de edad 12,7 ± 2,3 años). En todas las categorías del IMC, más del 50% de chicos y chicas siguen una dieta de muy baja calidad, que empeora progresivamente con el avance en edad. En ambos sexos, se observaron tendencias entre un nivel nutricional muy bajo con el desarrollo de sobrepeso. Asimismo, la obesidad abdominal por CC se relacionó con una puntuación baja en el Krece Plus en ambos sexos.Conclusiones: en escolares de Bogotá, una dieta de muy baja calidad se relacionó con alteraciones del estado nutricional (IMC y CC), especialmente entre chicas y adolescentes. Estos resultados deben alentar el desarrollo de intervenciones orientadas a mejorar los hábitos nutricionales entre los escolares colombianos.

Nivel y estado nutricional en niños y adolescentes de Bogotá, Colombia. Estudio FUPRECOL / Profile of nutritional status of children and adolescents from Bogotá, Colombia. The FUPRECOL study

Introducción: los objetivos de este estudio fueron analizar el nivel nutricional en una población de niños y adolescentes colombianos y determinar la posible relación entre el nivel nutricional y el estado nutricional según el índice de masa corporal (IMC) y la circunferencia de cintura (CC). Material y métodos: estudio transversal en 6.383 niños y adolescentes de entre 9 y 17,9 años de edad, de Bogotá, Colombia. Se aplicó de manera autodiligenciada el cuestionario Krece Plus validado en el estudio enKid como indicador del nivel nutricional con las categorías alto (test ≥ 9), medio (test 6-8) y bajo (test ≤ 5). Se tomaron medidas de peso, talla, CC, y se calculó el IMC como marcadores del estado nutricional. Resultados: de la población general, el 57,9% eran chicas (promedio de edad 12,7 ± 2,3 años). En todas las categorías del IMC, más del 50% de chicos y chicas siguen una dieta de baja calidad, que empeora con el avance en edad. En ambos sexos, se observaron tendencias entre un nivel nutricional bajo con el desarrollo de sobrepeso. Asimismo, la obesidad abdominal por CC se relacionó con una puntuación baja en el Krece Plus en ambos sexos. Conclusiones: en escolares de Bogotá, una dieta de muy baja calidad se relacionó con alteraciones del estado nutricional (IMC y CC), especialmente entre chicas y adolescentes. Estos resultados deben alentar el desarrollo de intervenciones orientadas a mejorar los hábitos nutricionales entre los escolares colombianos (AU)

Introduction: This study aimed to analyze the nutritional status among Colombian children and adolescents and to determine the relationship between the nutritional status according to the body mass index (BMI) and the waist circumference (WC). Methods: A cross-sectional study was conducted in 6.383 children and adolescents with age of 9 to 17.9 years old from Bogota, Colombia. Participants completed the Krece Plus questionnaire validated by the enKid study as an indicator of the nutritional level with the following categories: high (test ≥ 9), medium (test 6-8) and low (test ≤ 5). Other measures were: weight, height, WC and BMI as markers of the nutritional status. Results: Overall, 57.9% of the participants were girls (mean age 12.7 ± 2.3 years old). The nutritional status was low with out large differences by sex and decreasing by age. In all categories of BMI, over 50% of boys and girls follow lower-quality diet, shown worse with advancing age. In both sexes, trends were observed between low nutritional level with the development of overweight. Also, WC was associated with a lower score in the Krece Plus in both sexes. Conclusions: The low nutritional level is related to changes in the nutritional status (WC and BMI) in scholars from Bogota. These findings may encourage further interventions for the improvement of nutritional habits among scholars from Colombia (AU)

Vitamin B12 concentrations in pregnant Colombian women: analysis of nationwide data 2010.

BACKGROUND: Vitamin B12 deficiency is associated with many adverse health outcomes and is highly prevalent worldwide. The present study assesses the prevalence and socio-demographic factors associated with vitamin B12 deficiency in a representative sample of pregnant women in Colombia. METHOD: We used data from the cross-sectional, nationally representative survey (ENSIN, 2010). A total of 1.781, (13-49 years old) pregnant women were enrolled. Serum Vitamin B12 a concentration was determined by chemiluminescence and sociodemographic date was assessed by computer-assisted personal interview technology. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis. RESULTS: Vitamin B12 concentrations ranged from 45 to 1000 pg/mL (mean 299.2 pg/mL, 95% CI 290.6 to 303.7 pg/mL). A total of 18.6% of pregnant women had vitamin B12 concentrations below 200 pg/mL and 41.3% had concentrations between 200 and 300 pg/mL. Being of indigenous ethnicity, living in the east and living in a rural area showed the lowest mean values (273.2 pg/mL, 270.8 pg/mL and 290.1 pg/mL, respectively). The multivariate logistic regression shows that pregnant women belonging to the indigenous ethnic group OR 2.2, (95% CI 1.1 to 4.3), living in the pacific region (west) OR 4.4, (95% CI 2.8 to 6.9), or national territories (south) OR 2.3, (95% CI 1.4 to 3.7) were associated with a higher probability of serum vitamin B12 deficiency. CONCLUSION: The prevalence of vitamin B12 deficiency in Colombian pregnant women is substantial. Factors associated with depletion among pregnant women should be considered for future interventions in countries experiencing nutritional transition.

Vitamin B12 concentration and its association with sociodemographic factors in Colombian children: Findings from the 2010 National Nutrition Survey.

OBJECTIVE: Rapid changes in dietary patterns, economic development, and urbanization in low- to middle-income countries are fueling complex malnutrition states that need better characterization using population-level data. The aim of this study was to describe the key findings related to vitamin B12 status to identify the prevalence and associated sociodemographic factors in a representative sample of children in Colombia, based on the 2010 National Nutrition Survey. METHODS: We analyzed cross-sectional data from 6910 Colombian children between the ages of 5 and 12. Serum vitamin B12 concentrations were determined by chemiluminescence. Sociodemographic data was assessed by computer-assisted personal interview technology. RESULTS: Of the children assessed, 2.8% had vitamin B12 deficiency, defined as levels <200 pg/mL, and 18.1% had marginal vitamin B12 deficiency, defined as levels between 200 and 300 pg/mL. A multivariate logistic regression analysis revealed increased risks for vitamin B12 deficiency among children ages ≥9 y and for those living in the eastern, western, and southern regions of the country. No significant associations were found for ethnic groups, socioeconomic status, or urbanity levels. Being 11 y of age (odds ratio [OR], 2.16; 95% confidence interval [CI], 1.56-3.00; P = 0.0001), living in the west (Pacific) region of the country (OR, 3.92; 95% CI, 3.14-4.90; P = 0.0001), and being male (OR, 1.41; 95% CI, 1.20-1.65; P = 0.0001) were the factors most strongly associated with an increased risk for vitamin B12 deficiency. CONCLUSIONS: Compared with data from other Latin American countries, Colombian children have a lower prevalence of vitamin B12 deficiency; however the prevalence of marginal deficiency is substantial. Continued surveillance and implementation of interventions to improve dietary patterns among the high-risk groups identified should be considered.

Factores sociodemográficos y seguimiento prenatal asociados a la mortalidad perinatal en gestantes de Colombia / Sociodemographic factors and adequacy of prenatal care associated perinatal mortality in Colombian pregnant women

Introducción: el adecuado seguimiento clínico y el cumplimiento de los requerimientos nutricionales, son aspectos esenciales para el adecuado desarrollo fetal y la culminación exitosa del embarazo. El objetivo de este estudio fue determinar la asociación entre los factores sociodemográficos y el seguimiento prenatal asociados a la mortalidad perinatal en gestantes de Colombia. Material y métodos: estudio descriptivo y transversal secundario a la información obtenida en la Encuesta Nacional de la Situación Nutricional 2010 (ENSIN 2010) y la Encuesta Nacional de Demografía y Salud (ENDS 2010), en 14.754 mujeres gestantes de entre 13 y 44 años de edad. Los factores sociodemográficos: sexo del recién nacido, región geográfica (atlántica, oriental, central, pacífica, Bogotá, territorios nacionales), nivel socioeconómico- Sisbén (I al VI) y área geográfica (cabecera municipal, centro poblado, población dispersa), el seguimiento prenatal (control de peso, altura uterina, presión arterial, fetocardia, bioquímica sanguínea, análisis de orina) y la suplementación con hierro, calcio y ácido fólico se recogieron a través de una encuesta estructurada. Se establecieron asociaciones mediante la construcción de modelos de regresión logística binaria simple y multivariable. Resultados: de las variables sociodemográficas, residir en centros poblados, región oriental o pacífica, y pertenecer al nivel Sisbén I, son las que mostraron mayor frecuencia de muerte perinatal, con valores de 1,7%, 1,5%, 1,4% y 1,4%, respectivamente. Tras ajustar por sexo del recién nacido, área, región geográfica y puntaje de Sisbén, se encontró que un inadecuado seguimiento en el control del peso (OR 5,12), la presión arterial (OR 5,18), la bioquímica sanguínea (OR 2,19) y la suplementación con hierro (OR 2,09), calcio (OR 1,73) y ácido fólico (OR 2,73) se asociaron como factores predisponentes a la mortalidad perinatal. Conclusiones: la mortalidad perinatal cambia según los factores sociodemográficos y el seguimiento prenatal estudiados. El Estado podría usar los resultados de este estudio para fomentar intervenciones que mejoren el seguimiento prenatal durante la gestación (AU)

Background: an adequate monitoring and the compliance of the nutritional requirements are essential for fetal development and successful control of pregnancy outcomes. This study aimed to determine the association between sociodemographic factors and the pre-birth monitoring associated with perinatal mortality in pregnant women from Colombia. Methods: this was a cross-sectional analysis from the 2010 Colombian Demographic and Health Survey and the National Nutritional Survey that included 14 754 pregnant women between 13 and 44 years old. Sociodemographic factors included: new born sex, geographic region, socioeconomic status (SISBEN), pre-birth monitoring (weight control, uterus height, blood pressure, fetal cardiac activity, biochemistry essays, urine analysis) and the supplementation of iron, calcium and folic acid, were collected by structured questionnaire. Associations were established through multivariable and binary regression models. Results: sociodemographic factors such as living in high-density cities, pacific and western regions and low socioeconomic status (SISBEN I) showed a highest perinatal mortality with rates of 1.7%, 1.5%, 1.4% and 1.4%, respectively. After adjustment by new born sex, geographic region and SISBEN score, an adequate monitoring of weight control (OR = 5.12), blood pressure (OR = 5.18), biochemistry essays (OR = 2.19), supplementation of iron (OR = 2.09), calcium (OR=1.73) and folic acid (OR = 2.73) were associated as facilitators of perinatal mortality. Conclusions: perinatal mortality is determined by the sociodemographic factors and pre-birth follow-up included in this study. Government and decision makers can take these results to garbage actions aiming to improve pregnancy monitoring (AU)

[SOFT DRINKS CONSUMPTION AMONG PREGNANT WOMEN IN COLOMBIA: FACTORS ASSOCIATED]. / CONSUMO DE BEBIDAS CARBONATADAS ENTRE GESTANTES COLOMBIANAS: FACTORES ASOCIADOS.

OBJECTIVE: to examine the factors associated with regular consumption of soft drinks in Colombian pregnant. MATERIAL AND METHODS: a cross-sectional study was conducted of data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010), in 1.865 pregnant women aged between 13 and 49 years. Soft drink consumption and associated factors (pregnancy trimester, age, ethnicity, urbanicity, academic level, SISBEN score, and geographic region) were collected by structured questionnaire. Associations were established through a multivariable regression model. RESULTS: we found the 17% of pregnant women consume at least a daily soft drink. To be between 13 to 17 years old, belonging to an ethnic groups (afro-Colombian), being in the first pregnancy trimester and to belong to Sisbén level II showed the highest daily consumption pattern (23.8%, 22.8%, 21.4% and 20.9%). Regression models show that being between 13 to 17 years old OR 1.92 (IC95% 1.04-3.55); to reside in the eastern area OR 1.85 (IC95% 1.05-3.27), or central OR 1.73 (IC95% 1.01- 2.96), and being in the first pregnancy trimester OR 1.59 (IC95% 1.01-2.52); were associated with soft drinks daily consumption. CONCLUSIONS: the women studied show a high prevalence of daily consumption of soft drinks. Comprehensive interventions involving both nutritional and educational components are required.

Objetivo: examinar los factores asociados al consumo regular de bebidas carbonatadas (BCS) en gestantes colombianas. Métodos: estudio descriptivo transversal, secundario de la información obtenida en la Encuesta Nacional de la Situación Nutricional 2010 (ENSIN 2010), en 1.865 mujeres embarazas de entre 13 y 49 años de edad. El consumo de BCS y los factores asociados (edad materna, trimestre de embarazo, nivel de Sisbén, región y área geográfica, etnia y escolaridad), se recogieron mediante una encuesta estructurada. Se establecieron asociaciones mediante la construcción de modelos de regresión y factores asociados. Resultados: el 17% de las mujeres embarazadas consumen al menos una bebida BCS diaria. Tener entre 13 y 17 años de edad, pertenecer a la etnia afrocolombiana, cursar el primer trimestre de embarazo y agruparse en el Sisbén nivel II mostraron el mayor patrón de consumo diario (23,8%, 22,8%, 21,4% y 20,9%), respectivamente. Los modelos de regresión muestran que pertenecer al grupo de 13 a 17 años OR 1,92 (IC95% 1,04-3,55), residir en la zona oriental OR 1,85 (IC95% 1,05-3,27) o central OR 1,73 (IC95% 1,01-2,96) y cursar el primer trimestre de gestación OR 1,59 (IC95% 1,01-2,52) se asociaron como factores predisponentes al consumo diario de BCS. Conclusiones: las embarazadas de Colombia presentan una alta prevalencia de consumo diario de BCS, por lo que se recomiendan intervenciones integrales en las que estén involucrados el componente nutricional y educativo.

[SOCIODEMOGRAPHIC FACTORS AND ADEQUACY OF PRENATAL CARE ASSOCIATED PERINATAL MORTALITY IN COLOMBIAN PREGNANT WOMEN]. / FACTORES SOCIODEMOGRÁFICOS Y SEGUIMIENTO PRENATAL ASOCIADOS A LA MORTALIDAD PERINATAL EN GESTANTES DE COLOMBIA.

BACKGROUND: an adequate monitoring and the compliance of the nutritional requirements are essential for fetal development and successful control of pregnancy outcomes. This study aimed to determine the association between sociodemographic factors and the pre-birth monitoring associated with perinatal mortality in pregnant women from Colombia. METHODS: this was a cross-sectional analysis from the 2010 Colombian Demographic and Health Survey and the National Nutritional Survey that included 14 754 pregnant women between 13 and 44 years old. Sociodemographic factors included: new born sex, geographic region, socioeconomic status (SISBEN), pre-birth monitoring (weight control, uterus height, blood pressure, fetal cardiac activity, biochemistry essays, urine analysis) and the supplementation of iron, calcium and folic acid, were collected by structured questionnaire. Associations were established through multivariable and binary regression models. RESULTS: sociodemographic factors such as living in high-density cities, pacific and western regions and low socioeconomic status (SISBEN I) showed a highest perinatal mortality with rates of 1.7%, 1.5%, 1.4% and 1.4%, respectively. After adjustment by new born sex, geographic region and SISBEN score, an adequate monitoring of weight control (OR = 5.12), blood pressure (OR = 5.18), biochemistry essays (OR = 2.19), supplementation of iron (OR = 2.09), calcium (OR=1.73) and folic acid (OR = 2.73) were associated as facilitators of perinatal mortality. CONCLUSIONS: perinatal mortality is determined by the sociodemographic factors and pre-birth follow-up included in this study. Government and decision makers can take these results to garbage actions aiming to improve pregnancy monitoring.

Introducción: el adecuado seguimiento clínico y el cumplimiento de los requerimientos nutricionales, son aspectos esenciales para el adecuado desarrollo fetal y la culminación exitosa del embarazo. El objetivo de este estudio fue determinar la asociación entre los factores sociodemográficos y el seguimiento prenatal asociados a la mortalidad perinatal en gestantes de Colombia. Material y métodos: estudio descriptivo y transversal secundario a la información obtenida en la Encuesta Nacional de la Situación Nutricional 2010 (ENSIN 2010) y la Encuesta Nacional de Demografía y Salud (ENDS 2010), en 14.754 mujeres gestantes de entre 13 y 44 años de edad. Los factores sociodemográficos: sexo del recién nacido, región geográfica (atlántica, oriental, central, pacífica, Bogotá, territorios nacionales), nivel socioeconómico- Sisbén (I al VI) y área geográfica (cabecera municipal, centro poblado, población dispersa), el seguimiento prenatal (control de peso, altura uterina, presión arterial, fetocardia, bioquímica sanguínea, análisis de orina) y la suplementación con hierro, calcio y ácido fólico se recogieron a través de una encuesta estructurada. Se establecieron asociaciones mediante la construcción de modelos de regresión logística binaria simple y multivariable. Resultados: de las variables sociodemográficas, residir en centros poblados, región oriental o pacífica, y pertenecer al nivel Sisbén I, son las que mostraron mayor frecuencia de muerte perinatal, con valores de 1,7%, 1,5%, 1,4% y 1,4%, respectivamente. Tras ajustar por sexo del recién nacido, área, región geográfica y puntaje de Sisbén, se encontró que un inadecuado seguimiento en el control del peso (OR 5,12), la presión arterial (OR 5,18), la bioquímica sanguínea (OR 2,19) y la suplementación con hierro (OR 2,09), calcio (OR 1,73) y ácido fólico (OR 2,73) se asociaron como factores predisponentes a la mortalidad perinatal. Conclusiones: la mortalidad perinatal cambia según los factores sociodemográficos y el seguimiento prenatal estudiados. El Estado podría usar los resultados de este estudio para fomentar intervenciones que mejoren el seguimiento prenatal durante la gestación.

Características antropométricas y funcionales de corredores colombianos de élite de larga distancia / Anthropometric and functional characteristics of Colombian elite long-distance runners / Características antropométricas e funcionais de corredores colombianos de elite de longa distância

Objetivo: describir las características antropométricas y funcionales de corredores élite de larga distancia. Método: estudio transversal de 19 atletas élite profesionales (edad 28,2 ± 6,9 años). Se midieron 24 variables antropométricas, según las normas de la International Society for the Advancement of Kinanthropometry (ISAK). Se calcularon los tres componentes del somatotipo de Heath-Carter y se estimó la composición corporal con las ecuaciones propuestas por Siri, Matiegka, Jackson y Pollock. Como indicadores funcionales se midieron la capacidad funcional por VO(2) máx por ergometría, la potencia anaeróbica por salto vertical y la capacidad anaeróbica por el test de Wingate. Resultados: en cuanto a la composición corporal se hallaron: porcentaje de masa grasa de 13,3 ± 3,2; proporción muscular de 47,3 ± 2,5% e índice de adiposidad corporal de 24,1 ± 3,3. El somatotipo grupal fue el mesomorfo-balanceado (3,6-4,0-2,1). Con respecto a los indicadores funcionales, se hallaron: valores promedio de capacidad aeróbica por VO(2) máx de 42,6 ± 8,1 mL•kg-1•min-1; potencia anaeróbica de 106,0 ± 31,8 kg•s-1 y capacidad anaeróbica pico de 6501,0 ± 1831,6 K/jul. Conclusiones: estos resultados pueden suministrar un perfil de corredores de larga distancia utilizable como meta para el desarrollo de atletas, así como dar información para el entrenamiento y el énfasis táctico.

Objective: To evaluate the anthropometric and physical performance characteristics of elite long-distance runners. Methods: A cross-sectional study in 19 male competitive long-distance runners of national level (age 28.2 ± 6.9 years). A total of 24 anthropometric variables were measured according to the International Society for the Advancement of Kinanthropometry (ISAK) statements. The Heath-Carter method and the formula proposed by Siri, Matiegka, Jackson and Pollock were used to calculate the somatotype and the body composition, respectively. Ergospirometry VO(2) max, Vertical Jump Test and the Wingate Test were used as functional indicators. Results: Regarding body composition, we found fat mass percentage 13.3 ± 3.2; muscle mass 47.3 ± 2.5%, and body adiposity index 24.1 ± 3.3. Somatotype profile was the mesomorphic-balanced (3.6-4.0- 2.1). Mean values of functional tests with their standard deviations were: VO(2) máx (mL•kg-1•min-1) 42.6 ± 8.1; anaerobic power 106.0 ± 31.8 kg•s-1, and anaerobic capacity 6501.0 ± 1831.6 K/jul. Conclusion: These results may provide a profile of long-distance runners that can be used as training targets for developing athletes. The results may also provide information for training and tactical emphasis.

Objetivo: descrever as características antropométricas e funcionais de corredores elite de longa distância. Método: estudo transversal de 19 atletas elite profissionais (idade 28,2 ± 6,9 anos). Mediram-se 24 variáveis antropométricas, segundo as normas da International Society for the Advancement of Kinanthropometry (ISAK). Calcularam-se os três componentes do somatótipo de Heath-Carter e se estimou a composição corporal com as equações propostas por Siri, Matiegka, Jackson e Pollock. Como indicadores funcionais se mediram a capacidade funcional por VO(2) máx por ergometria, a potência anaeróbica por salto vertical e a capacidade anaeróbica pelo teste de Wingate. Resultados: quanto à composição corporal se acharam: porcentagem de massa gordurosa de 13,3 ± 3,2; proporção muscular de 47,3 ± 2,5% e índice de adiposidade corporal de 24,1 ± 3,3. O somatótipo grupal foi o mesomorfo-balançado (3,6-4,0-2,1). Com respeito aos indicadores funcionais, acharam-se: valorizes média de capacidade aeróbica por VO(2) máx de 42,6 ± 8,1 mL•kg-1•min-1; potência anaeróbica de 106,0 ± 31,8 kg•s-1 e capacidade anaeróbica bico de 6501,0 ± 1831,6 K/jul. Conclusões: estes resultados podem fornecer um perfil de corredores de longa distância utilizável como meta para o desenvolvimento de atletas, bem como dar informação para o treinamento e a ênfase tática.

Consumo de bebidas carbonatadas entre gestantes colombianas: factores asociados / Soft drinks consumption among pregnant women in Colombia: factors associated

Objetivo: examinar los factores asociados al consumo regular de bebidas carbonatadas (BCS) en gestantes colombianas. Métodos: estudio descriptivo transversal, secundario de la información obtenida en la Encuesta Nacional de la Situación Nutricional 2010 (ENSIN 2010), en 1.865 mujeres embarazas de entre 13 y 49 años de edad. El consumo de BCS y los factores asociados (edad materna, trimestre de embarazo, nivel de Sisbén, región y área geográfica, etnia y escolaridad), se recogieron mediante una encuesta estructurada. Se establecieron asociaciones mediante la construcción de modelos de regresión y factores asociados. Resultados: el 17% de las mujeres embarazadas consumen al menos una bebida BCS diaria. Tener entre 13 y 17 años de edad, pertenecer a la etnia afrocolombiana, cursar el primer trimestre de embarazo y agruparse en el Sisbén nivel II mostraron el mayor patrón de consumo diario (23,8%, 22,8%, 21,4% y 20,9%), respectivamente. Los modelos de regresión muestran que pertenecer al grupo de 13 a 17 años OR 1,92 (IC95% 1,04-3,55), residir en la zona oriental OR 1,85 (IC95% 1,05-3,27) o central OR 1,73 (IC95% 1,01-2,96) y cursar el primer trimestre de gestación OR 1,59 (IC95% 1,01-2,52) se asociaron como factores predisponentes al consumo diario de BCS. Conclusiones: las embarazadas de Colombia presentan una alta prevalencia de consumo diario de BCS, por lo que se recomiendan intervenciones integrales en las que estén involucrados el componente nutricional y educativo (AU)

Objective: to examine the factors associated with regular consumption of soft drinks in Colombian pregnant. Material and methods: a cross-sectional study was conducted of data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010), in 1.865 pregnant women aged between 13 and 49 years. Soft drink consumption and associated factors (pregnancy trimester, age, ethnicity, urbanicity, academic level, SISBEN score, and geographic region) were collected by structured questionnaire. Associations were established through a multivariable regression model. Results: we found the 17% of pregnant women consume at least a daily soft drink. To be between 13 to 17 years old, belonging to an ethnic groups (afro-Colombian), being in the first pregnancy trimester and to belong to Sisbén level II showed the highest daily consumption pattern (23.8%, 22.8%, 21.4% and 20.9%). Regression models show that being between 13 to 17 years old OR 1.92 (IC95% 1.04-3.55); to reside in the eastern area OR 1.85 (IC95% 1.05-3.27), or central OR 1.73 (IC95% 1.01- 2.96), and being in the first pregnancy trimester OR 1.59 (IC95% 1.01-2.52); were associated with soft drinks daily consumption. Conclusions: the women studied show a high prevalence of daily consumption of soft drinks. Comprehensive interventions involving both nutritional and educational components are required (AU)

Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. This study aimed to determine the effects of supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis. DESIGN: A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE, and OVID were searched between January and March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale. RESULTS: Nine studies (n = 772) were included in both systematic review and meta-analysis. Multimodal interventions including aerobic exercise, resistance training, and stretching improved CRF symptoms (SMD = -0.23; 95% CI: -0.37 to -0.09; P = 0.001). These effects were also significant in patients undergoing chemotherapy (P < 0.0001). Nonsignificant differences were found for resistance training interventions (P = 0.30). Slight evidence of publication bias was observed (P = 0.04). The studies had a low risk of bias (PEDro scale mean score of 6.4 (standard deviation (SD) ± 1.0)). CONCLUSION: Supervised multimodal exercise interventions including aerobic, resistance, and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anticancer treatments.

[Demographic and socioeconomic differences in consumption of sugar-sweetened beverages among Colombian children and adolescents]. / DIFERENCIAS DEMOGRÁFICAS Y SOCIOECONÓMICAS ASOCIADAS AL CONSUMO DE BEBIDAS AZUCARADAS EN NIÑOS Y ADOLESCENTES COLOMBIANOS.

INTRODUCTION: Sugar-sweetened beverages (SSB) are becoming a common component in the diets among children and adolescents, and its consumption is associated with an increased risk factors for cardiovascular disease. The aim of the present study was to describe the consumption of sugar-sweetened beverages among Colombian children and adolescents and to examine whether differences by demographic and socioeconomic according to gender. METHODS: We used data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010) for 10,373 children and adolescents between 5 and 17 years old. SSB intake was based on intake from regular soda and/ or concentrated drinks. Demographic factors (sex, age, ethnicity, urbanicity, area and geographic region) and socioeconomic level (social class) were collected by structured questionnaire. Associations were established through a multivariate logistic regression. All analyzes were calculated by complex samples. RESULTS: Nationwide, 23% of girls and 22.4% of boys drank SSB at least once a week. Differences by demographic factors were observed for SSB consumption. In girls, factors associated with a greater odds for SSB intake (≥ 1 time/week) were aged 14 to 17 years old [OR = 1.65 (95%CI = 1.32, 2.06)], living in the central region [OR = 2.42 (95%CI = 1.81, 3.25)] and urban area [OR = 1.77 (95%CI = 1.42, 2.20)]. In boys, the multivariate logistic regression shows that adolescents aged 14 to 17 years old [OR = 1.96 (95%CI = 1.58, 2.24)], living in the national territories (South) [OR = 2.42 (95%CI = 1.77, 3.32)] and urban area [OR = 1.79 (95%CI = 1.45, 2.20)] were associated with a higher probability of SSB consumption. Social class was not associated with SSB intake. CONCLUSIONS: SSB intake varies by certain demographic factors. Government can use findings from this study to tailor efforts to decrease SSB intake and to encourage consumption of more healthful beverages (e.g, water) among Colombian children and adolescents.

Introducción: las bebidas azucaradas (BA) se estan convirtiendo en un componente comun en las dietas de ninos y adolescentes y su consumo se relaciona con factores de riesgo de enfermedad cardiovascular. El objetivo de este estudio fue describir el consumo de BA entre ninos y adolescentes colombianos y examinar las diferencias demograficas y socioeconomicas de acuerdo al sexo. Métodos: estudio descriptivo y transversal secundario de la informacion obtenida en la Encuesta Nacional de la Situacion Nutricional 2010 (ENSIN 2010), en 10.373 ninos y adolescentes, entre 5 y 17 anos. El consumo de BA (bebidas carbonatadas y/o concentrados azucarados), los factores demograficos (sexo, edad, etnia, urbanidad, region y area geografica) y el nivel sociodemografico (puntaje de Sisben) se recogieron por encuesta estructurada. Se establecieron asociaciones mediante la construccion de modelos de regresion logistica binaria simple y multivariable. Resultados: a nivel nacional, el 23% de las ninas y el 22,4% de los ninos acusaron un consumo de al menos una vez a la semana de BA y se observan diferencias significativas por factores demograficos. En las ninas, los factores asociados a la ingesta de BA (≥ 1 vez/sem) eran las pertenecientes al grupo entre 14 y 17 anos de edad [OR = 1,65 (IC95% 1,32-2,06)], las residentes de la region central [OR = 2,42 (IC95% 1,81-3,25)] y las procedentes de las areas urbanas [OR 1,77 (IC95% 1,42-2,20)]. En los ninos, la regresion logistica multivariante muestra que los adolescentes entre 14 y 17 anos de edad [OR= 1,96 (IC 95% 1,58-2,24)], procedentes de los territorios nacionales [OR = 2,42 (IC95% 1,77-3,32)] y los residentes del area urbana [OR 1,79(IC95% 1,45-2.20)] se asociaron con una mayor probabilidad de consumo de BA. La clase social no se asocio con la ingesta de BA. Conclusiones: el consumo de BA cambia segun los factores sociodemograficos estudiados. El Estado podria usar los resultados de este estudio para fomentar la disminucion del consumo regular de BA e incentivar el consumo de bebidas saludables (como el agua) entre los ninos y adolescentes de Colombia.

Diferencias demográficas y socioeconómicas asociadas al consumo de bebidas azucaradas en niños y adolescentes colombianos / Demographic and socioeconomic differences in consumption of sugar-sweetened beverages among colombian children and adolescents

Introducción: las bebidas azucaradas (BA) se estan convirtiendo en un componente comun en las dietas de ninos y adolescentes y su consumo se relaciona con factores de riesgo de enfermedad cardiovascular. El objetivo de este estudio fue describir el consumo de BA entre ninos y adolescentes colombianos y examinar las diferencias demograficas y socioeconomicas de acuerdo al sexo. Métodos: estudio descriptivo y transversal secundario de la informacion obtenida en la Encuesta Nacional de la Situacion Nutricional 2010 (ENSIN 2010), en 10.373 ninos y adolescentes, entre 5 y 17 anos. El consumo de BA (bebidas carbonatadas y/o concentrados azucarados), los factores demograficos (sexo, edad, etnia, urbanidad, region y area geografica) y el nivel sociodemografico (puntaje de Sisben) se recogieron por encuesta estructurada. Se establecieron asociaciones mediante la construccion de modelos de regresion logistica binaria simple y multivariable. Resultados: a nivel nacional, el 23% de las ninas y el 22,4% de los ninos acusaron un consumo de al menos una vez a la semana de BA y se observan diferencias significativas por factores demograficos. En las ninas, los factores asociados a la ingesta de BA (≥ 1 vez/sem) eran las pertenecientes al grupo entre 14 y 17 anos de edad [OR = 1,65 (IC95% 1,32-2,06)], las residentes de la region central [OR = 2,42 (IC95% 1,81-3,25)] y las procedentes de las areas urbanas [OR 1,77 (IC95% 1,42-2,20)]. En los ninos, la regresion logistica multivariante muestra que los adolescentes entre 14 y 17 anos de edad [OR= 1,96 (IC 95% 1,58-2,24)], procedentes de los territorios nacionales [OR = 2,42 (IC95% 1,77-3,32)] y los residentes del area urbana [OR 1,79(IC95% 1,45-2.20)] se asociaron con una mayor probabilidad de consumo de BA. La clase social no se asocio con la ingesta de BA. Conclusiones: el consumo de BA cambia segun los factores sociodemograficos estudiados. El Estado podria usar los resultados de este estudio para fomentar la disminucion del consumo regular de BA e incentivar el consumo de bebidas saludables (como el agua) entre los ninos y adolescentes de Colombia (AU)

Introduction: sugar-sweetened beverages (SSB) are becoming a common component in the diets among children and adolescents, and its consumption is associated with an increased risk factors for cardiovascular disease. The aim of the present study was to describe the consumption of sugar-sweetened beverages among Colombian children and adolescents and to examine whether differences by demographic and socioeconomic according to gender. Methods: we used data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010) for 10 373 children and adolescents between 5 and 17 years old. SSB intake was based on intake from regular soda and/ or concentrated drinks. Demographic factors (sex, age, ethnicity, urbanicity, area and geographic region) and socioeconomic level (social class) were collected by structured questionnaire. Associations were established through a multivariate logistic regression. All analyzes were calculated by complex samples. Results: nationwide, 23% of girls and 22.4% of boys drank SSB at least once a week. Differences by demographic factors were observed for SSB consumption. In girls, factors associated with a greater odds for SSB intake (≥ 1 time/week) were aged 14 to 17 years old [OR = 1.65 (95%CI = 1.32, 2.06)], living in the central region [OR = 2.42 (95%CI = 1.81, 3.25)] and urban area [OR = 1.77 (95%CI = 1.42, 2.20)]. In boys, the multivariate logistic regression shows that adolescents aged 14 to 17 years old [OR = 1.96 (95%CI = 1.58, 2.24)], living in the national territories (South) [OR = 2.42 (95%CI = 1.77, 3.32)] and urban area [OR = 1.79 (95%CI = 1.45, 2.20)] were associated with a higher probability of SSB consumption. Social class was not associated with SSB intake. Conclusions: SSB intake varies by certain demographic factors. Government can use findings from this study to tailor efforts to decrease SSB intake and to encourage consumption of more healthful beverages (e.g, water) among Colombian children and adolescents (AU)