From recreational to income-generating opportunities: assessment of public preferences for non-wood forest products in the Czech Republic.

With the alarming increase in dying trees and massive logging in the Czech forests due to bark beetle infestation, the collection of non-wood forest products, a beneficial recreational activity in the Czech Republic, is now being promoted as an alternative to wood provisioning services. This paper aims to present findings on the non-wood forest product preferences in the country as part of a baseline assessment for promoting the usage. This study relied on the 2019 national survey data of public preferences in collecting forest berries, mushrooms, honey, and medicinal herbs. K-means cluster analysis was employed to classify the respondents. A binary logistic regression with a conditional forward approach was employed to identify the potential predictors of the high preference for each non-wood forest product. Data from 1,050 online respondents were included, and two groups of respondents were clustered based on their preferences for the entire non-wood forest, i.e., higher and lower utilization. The regression analysis revealed that frequent forest visitors were the primary predictor of high utilization of all non-wood forest products (between 1.437 to 4.579 odd ratios), in addition to age, gender, and location of the forest property. By clustering the respondents based on the high and low preferences in utilizing non-wood forest products, the promotion of this service, from recreational to potential livelihood activities and economic benefits, can be better targeted, e.g., target customer, infrastructure development in the location with high preferences, scenarios based on the type of owners (municipal or private forest owners), which in accordance to the national forest policy and laws, and, at the same time, maintain the ecological stability.

Phylogeography and population genetic structure of the cardinal tetra (Paracheirodon axelrodi) in the Orinoco basin and Negro River (Amazon basin): evaluating connectivity and historical patterns of diversification.

The Neotropics contain one of the most diverse assemblages of freshwater fishes worldwide. Part of this diversity is shared between the Orinoco and Amazon basins. These basins have been separated for a long time due to the Vaupes Arch, rising between 10-11 Ma. Today, there is only one permanent connection between the Orinoco and Negro (Amazon) basins, known as the Casiquiare Canal. However, alternative corridors allowing fish dispersion between both basins have been proposed. The cardinal tetra (Paracheirodon axelrodi), the most important fish in the ornamental world market, is distributed in both basins. Here we investigated P. axelrodi phylogeography, population structure, and potential routes of migration and connectivity between the two basins. A total of 468 bp of the mitochondrial gene (COI), 555 bp of the nuclear gene fragment (MYH6), and eight microsatellite loci were analyzed. As a result, we found two major genetic clusters as the most likely scenario (K = 2), but they were not discreetly distributed between basins. A gradient of genetic admixture was observed in Cucui and São Gabriel da Cachoeira, between the upper Negro River and the upper Orinoco. Samples from the middle-lower Negro River were highly structured. Cucui (Negro basin) was more similar to the Orinoco than to the rest of the Negro basin populations. However, substructure was also observed by the discriminant analysis, fixation indices and other hierarchichal structure analyses (K = 3 - 6), showing three major geographic clusters: Orinoco, Cucui, and the remaining Negro basin. Unidirectional migration patterns were detected between basins: via Cucui toward Orinoco and via the remaining of the Negro basin toward Orinoco. Results from the Relaxed Random Walk analysis support a very recent origin of this species in the headwater Orinoco basin (Western Guiana Shield, at late Pleistocene) with a later rapid colonization of the remaining Orinoco basin and almost simultaneously the Negro River via Cucui, between 0.115 until about 0.001 Ma. Historical biogeography and population genetic patterns observed here for Cardinal tetra, seem to be better explained by river capture, physical, or ecological barriers than due to the geographic distance.

Managing the challenges of climate change mitigation and adaptation strategies in Ghana.

Ghana's economy is climate sensitive as more than 80% of its agricultural production is rainfall dependent, with only 2% of irrigation potential used. This has consequences under changing climate, with the impact projected to intensify if things go in a business-as-usual scenario. The manifestation of climate change impact is evident in other sectors of the economy, which requires proactiveness to adapt and mitigate through the development and execution of national adaptation strategies. This research reviews the impact of climate change and some interventions made toward its management. The study explored peer-reviewed journals, policy documents, and technical reports for relevant materials that chronicle programmes and measures to address the challenges of climate change. The research revealed that Ghana had experienced about 1 °C rise in temperature over the past four decades and sea level rise with socioeconomic consequences including decreased agricultural productivity and inundation of coastal communities. Policy interventions have resulted in the introduction of several mitigative and adaptation programmes, such as building resilience in various economic sectors. The study highlighted the progress and challenges to climate change implementation programmes and future policy implementation plans. Inadequate funding of programmes and projects was identified as a critical challenge to achieving climate change policy goals and objectives. We recommend more political will from the government and stakeholders towards policy implementation and greater commitment to providing adequate funding for programmes and project implementation to ensure the success of local climate action for adaptation and mitigation, as well as for sustainable development.

Phenotypic and genotypic parallel evolution in parapatric ecotypes of Senecio.

The independent and repeated adaptation of populations to similar environments often results in the evolution of similar forms. This phenomenon creates a strong correlation between phenotype and environment and is referred to as parallel evolution. However, we are still largely unaware of the dynamics of parallel evolution, as well as the interplay between phenotype and genotype within natural systems. Here, we examined phenotypic and genotypic parallel evolution in multiple parapatric Dune-Headland coastal ecotypes of an Australian wildflower, Senecio lautus. We observed a clear trait-environment association in the system, with all replicate populations having evolved along the same phenotypic evolutionary trajectory. Similar phenotypes have arisen via mutational changes occurring in different genes, although many share the same biological functions. Our results shed light on how replicated adaptation manifests at the phenotypic and genotypic levels within populations, and highlight S. lautus as one of the most striking cases of phenotypic parallel evolution in nature.

Evaluation of two microcosm systems for co-treatment of LDPEoxo and lignocellulosic biomass for biochar production.

BACKGROUND: The co-transformation of solid waste of natural and anthropogenic origin can be carried out through solid-state-fermentation systems to obtain bio-products with higher added value and lower environmental impact. METHODS: To evaluate the effect of Pleurotus ostreatus on co-transformation of oxo-degradable low-density polyethylene (LDPEoxo) sheets and lignocellulosic biomass (LCB), were assembled two 0.75 L microcosm systems in vertical (VMS) and horizontal (HMS) position. The pre-treated sheets with luminescent O2 plasma discharges were mixed with pine bark, hydrolyzed brewer's yeast and paper napkin fragments and incubated for 135 days at 20 ± 1.0 °C in the presence of the fungus. With the co-transformation residues, biochar (BC) was produced at 300 ± 1.0 °C (BC300) for 1 h, then used to carry out adsorption studies, using the malachite green dye (MG) at pH 4.0, 7.0 and 9.0 ± 0.2. Finally, the biochar was the substrate for the germination of carnation seeds (Dianthus caryophyllus) and Ray-grass (Lolium sp.) in vitro. RESULTS: For HMS, the decrease in static contact angle (SCA) was 63.63% (p = 0.00824) and for VMS 74.45% (p = 0.00219), concerning the pristine. Plastic roughness in VMS was higher (26%) concerning the control. Throughout the 135 days, there were fungal growth and consequently laccase (Lac), manganese peroxidase (MnP) and lignin peroxidase (LiP) activities. During the first 75 days, CO2 production increased to 4.78 ± 0.01 and 4.98 ± 0.01 mg g-1 for HMS and VMS, respectively. In MG adsorption studies, the highest amount of the colourant adsorbed at both pH 4.0 and 7.0 ± 0.2. CONCLUSIONS: Finally, the biochar or the biochar enriched with low concentrations of plant growth-promoting microorganisms and inorganic fertilizer favours the germination of Dianthus caryophyllus and Lolium sp., seeds.

Non-domestic wastewater treatment with fungal/bacterial consortium followed by Chlorella sp., and thermal conversion of the generated sludge.

Liquid waste from biological stains is considered non-domestic wastewater difficult to treat, generating high environmental impact. Therefore, the objective of this work was to carry out secondary and tertiary treatment of these effluents at a pilot scale, using a fungal/bacterial consortium followed by Chorella sp., for 15 days. In addition, to obtain an adsorbent material for Malachite Green dye removal, sludge generated in the plant and pine bark co-pyrolysis was performed. For microalgae isolation and selection of the Chlorophyceae class, Chlorococcales order, and Chorella sp. genus Winogradsky columns were employed. After 15 days of pilot plant treatment, removal percentages of 91 ± 2%, 90 ± 4% and 17 ± 2% were obtained for Colour Units, Chemical Oxygen Demand and Nitrates, respectively. Two types of class II biochar (BC500 and BC700) and one of class III (BC300) were produced. The highest value for Fixed carbon (FC) was obtained at 300 °C (27.3 ± 3%), decreasing as the temperature increased by 25.9 ± 5% and 24.8 ± 2%, for BC500 and BC700, respectively. Biochar yield was 62.1 ± 3%, 46.3 ± 4% and 31.6 ± 3% for BC300, BC500 and BC700, respectively. Finally, BC500 and BC700 biochar efficiently adsorbed Malachite Green obtaining qe values of 0.290 ± 0.032, 0.281 ± 0.015, 0.186 ± 0.009 and 0.191 ± 0.012 mg g-1 at pH values of 4.0 and 8.0 ± 0.2, respectively. Pseudo-second order model demonstrated a chemical adsorption took place, which was influenced by pH. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-021-02780-1.

Key criteria for considering decentralization in municipal wastewater management.

Wastewater pollution problems are associated with population growth and the concentration of population in large urban centers. According to United Nations projections for 2050, the world population will reach 9 billion people, increasing the pressures on water resources due to their demand and pollution. Based on UNICEF and World Health Organization estimates, 2.4 billion people worldwide currently lack access to improved sanitation facilities, with 946 million practicing open defecation. Decentralized wastewater treatment systems are a viable and necessary alternative for wastewater management, thus, minimizing environmental impacts, facilitating resource recovery, and providing rural and peri-urban inhabitants with access to basic sanitation. This literature review article uses the multicriteria analysis tool to present the key economic, institutional, social, environmental, and technological aspects, criteria, and indicators that must be considered for successful decentralized system implementation planning to strengthen basic sanitation service coverage in the rural and peri-urban areas where it does not exist.

Ethical guidelines on cardiopulmonary resuscitation in the context of the COVID-19 pandemic in Colombia / [Pautas éticas para la reanimación cardiopulmonar en el contexto de la pandemia de COVID-19 en Colombia].

The pandemic caused by COVID19 is associated with an increase in the number of cases of cardiorespiratory arrest, which has resulted in ethical concerns regarding the enforceability of cardiopulmonary resuscitation, as well as the conditions to carry it out. The risk of aerosol transmission and the clinical uncertainties about the efficacy, the potential sequelae, and the circumstances that could justify limiting this procedure during the pandemic have multiplied the ethical doubts on how to proceed in these cases. Based on ethical and legal grounds, this paper offers a practical guide on how to proceed in the clinical setting in cases of cardiopulmonary arrest during the pandemic. The criteria of justice, benefit, no harm, respect for autonomy, precaution, integrity, and transparency are asserted in an organized and practical framework for decision-making regarding cardiopulmonary resuscitation.

La pandemia de COVID-19 se ha asociado con un incremento en el número de casos de paro cardiorrespiratorio y con ello han aumentado las inquietudes éticas en torno a la exigencia de la reanimación cardiopulmonar, así como sobre las condiciones para realizarla. El riesgo de contagio por aerosoles y las incertidumbres clínicas sobre la eficacia, las potenciales secuelas y las circunstancias que podrían justificar la limitación del procedimiento durante la pandemia, han multiplicado las dudas éticas sobre cómo proceder en estos casos. Con base en fundamentos éticos y jurídicos, en el presente artículo se ofrece una guía práctica sobre cómo proceder en los casos de paro cardiopulmonar en el contexto de la pandemia. Los criterios de justicia, beneficio, no daño, respeto a la autonomía, precaución, integridad y transparencia, se presentan de forma organizada y práctica para la adopción de decisiones en materia de reanimación cardiopulmonar.

Pautas éticas para la reanimación cardiopulmonar en el contexto de la pandemia de COVID-19 en Colombia / Ethical guidelines on cardiopulmonary resuscitation in the context of the COVID-19 pandemic in Colombia

La pandemia de COVID-19 se ha asociado con un incremento en el número de casos de paro cardiorrespiratorio y con ello han aumentado las inquietudes éticas en torno a la exigencia de la reanimación cardiopulmonar, así como sobre las condiciones para realizarla. El riesgo de contagio por aerosoles y las incertidumbres clínicas sobre la eficacia, las potenciales secuelas y las circunstancias que podrían justificar la limitación del procedimiento durante la pandemia, han multiplicado las dudas éticas sobre cómo proceder en estos casos. Con base en fundamentos éticos y jurídicos, en el presente artículo se ofrece una guía práctica sobre cómo proceder en los casos de paro cardiopulmonar en el contexto de la pandemia. Los criterios de justicia, beneficio, no daño, respeto a la autonomía, precaución, integridad y transparencia, se presentan de forma organizada y práctica para la adopción de decisiones en materia de reanimación cardiopulmonar.

The pandemic caused by COVID19 is associated with an increase in the number of cases of cardiorespiratory arrest, which has resulted in ethical concerns regarding the enforceability of cardiopulmonary resuscitation, as well as the conditions to carry it out. The risk of aerosol transmission and the clinical uncertainties about the efficacy, the potential sequelae, and the circumstances that could justify limiting this procedure during the pandemic have multiplied the ethical doubts on how to proceed in these cases. Based on ethical and legal grounds, this paper offers a practical guide on how to proceed in the clinical setting in cases of cardiopulmonary arrest during the pandemic. The criteria of justice, benefit, no harm, respect for autonomy, precaution, integrity, and transparency are asserted in an organized and practical framework for decision-making regarding cardiopulmonary resuscitation.

Tertiary treatment (Chlorella sp.) of a mixed effluent from two secondary treatments (immobilized recombinant P. pastori and rPOXA 1B concentrate) of coloured laboratory wastewater (CLWW).

Industrial development has increased wastewater (WW) volume; generating contamination and disturbing ecosystems, because of breeching disposal parameters. In this work, Coloured Laboratory Wastewater (CLWW), (1500.00 colour units, CU) was separately submitted to two secondary treatments. For the first one CLWW was treated for three cycles C1, C2 and C3 with P. pastoris X33/pGAPZαA-LaccPost-Stop producing rPOXA 1B laccase, immobilized in calcium alginate beads. For the second-one, rPOXA 1B enzyme concentrate was used (three processes: P1, P2, and P3). Both treatments were carried out in a 15 L reactor with 10 L effective work volume (EWV) with 72 h hydraulic retention time. C1, C2, and C3 effluents were flocculated and filtered through quartzite sand, while P1, P2, and P3 effluents were only filtered through quartzite sand. The mixture of secondary effluents was submitted to a tertiary treatment with Chlorella sp. For C1, C2, C3, P1, P2, and P3, CU removal was of 99.16, 99.58, 99.53, 96.72, 97.05 and 96.47%, respectively. Discharge parameters, total organic carbon (TOC), inorganic carbon (IC), chemical oxygen demand (COD) and biological oxygen demand (BOD5) decreased, although they reached different final values. After the tertiary treatment (144 h) effluent discharge parameters were reduced to 34 ± 4 CU, TOC to 6.6 ± 0.9 mg L-1 and COD to 155 ± 4 mg L-1. It was demonstrated that secondary treatments (immobilized recombined cells or recombinant enzyme concentrate) combined with Chlorella sp., (tertiary treatment) attained a considerable removal of discharge parameters, demonstrating a promissory alternative for CLWW sequential treatment.

Derecho al consumo informado: el caso de las bebidas azucaradas en Colombia / Right to informed consumption: the case of sugar-sweetened beverages in Colombia

Introducción: se presenta un análisis sobre el derecho al consumo informado en el caso de las bebidas azucaradas, a través del recorrido administrativo y judicial en Colombia. Metodología: se hace desde una perspectiva jurídica, bioética y médica, señalando cómo la protección judicial de este derecho se da gracias al activísimo social y judicial que se enfrenta con el lobby de la industria, cuyos intereses también inciden, no en el ámbito del acceso a la justicia, pero si en el del diseño de políticas públicas en salud para reducir el consumo de bebidas azucaradas. Conclusiones: de la revisión de la literatura se encontró que ciertas enfermedades no transmisibles se asocian con el consumo de estos productos, por lo cual en diferentes regiones del mundo se han replanteado medidas para mitigar su impacto, mientras en Colombia el escenario desde las políticas públicas no ha sido favorable.

Introduction: an analysis of the right to informed sugar-sweetened beverages consumption is herein presented from the administrative and legal background in Colombia. Methodology: a study conducted from the legal, bioethical and medical perspective, pointing out how legal protection of this right is possible thanks to social and legal activism which faces industrial lobby whose interests do not influence the access to justice institutions but does influence the design of health public policy for reducing sugar-sweetened beverages intake. Conclusions: our review of the literature found that certain non-communicable diseases are associated with the intake of these products for which measures to mitigate their impact have been reconsidered in different regions of the world, while in Colombia the public policy scenario has been unfavorable.

[SAFETY OF THE TREATMENT FOR VOLUNTARY PREGNANCY TERMINATION BY GESTATIONAL AGE. MEDELLÍN, COLOMBIA, 2013-2014].

OBJECTIVE: To describe the safety of medical and surgical treatments used in women seeking voluntary pregnancy termination. METHODS: Historical cohort of all pregnant women with up to 26 weeks of gestation who received treatment for voluntary pregnancy termination in a referral institution in Medellín, Colombia, between January 2013 and December 2014.Sampling was consecutive. Measured variables included sociodemographic and obstetric variables, undesired effects, and complications of the voluntary pregnancy termination treatment. A descriptive analysis was carried out. RESULTS: Overall, 87 women were included. The mean age at the time of termination was 24 years (inter-quartile range [IQR] = 12), 69.0% were single, and 73,4% were unemployed. The main reason for termination was the risk to the mother's health in 61,0% of cases, followed by a history of sexual violence in 26.4% and fetal malformations in 12.6%; a total of 70 women (80,4%) had less than 18 weeks of gestation and were treated with misoprostol plus manual vacuum aspiration; 17 (19,6%) had between 18 and 26 weeks of gestation and were treated with misoprostol followed by dilation and curettage. The first group (gestational age <18 weeks) experienced undesired effects such as pain and vomiting; in the second group (> or equal to 18 weeks), 41.0% of the women experienced hemorrhage. CONCLUSIONS: The risk to the mother's health was the main reason for the termination of pregnancy. Termination before 18 weeks was found to be safe, while termination between 18 and 26 weeks using misoprostol and curettage was associated with a high frequency of hemorrhage.

TITULO: SEGURIDAD DEL TRATAMIENTO DE LA INTERRUPCIÓN VOLUNTARIA DEL EMBARAZO SEGÚN EDAD GESTACIONAL EN MEDELLÍN, COLOMBIA, 2013-2014. OBJETIVO: describir la seguridad del tratamiento médico-quirúrgico empleado en mujeres que acuden a interrupción voluntaria del embarazo. METODOS: cohorte histórica. Se incluyeron todas las mujeres embarazadas, hasta con 26 semanas de edad gestacional, a quienes se les dio tratamiento para interrupción voluntaria del embarazo en una institución de referencia en Medellín, Colombia, entre enero de 2013 y diciembre de 2014. Muestreo consecutivo. Se midieron las variables sociodemográficas obstétricas, los efectos no deseados y las complicaciones en el tratamiento de la interrupción voluntaria del embarazo. Se hizo análisis descriptivo. RESULTADOS: se incluyeron 87 mujeres, la mediana de edad de las mujeres al momento de la interrupción fue de 24 años (rango intercuartílico [Rq] = 12), el 69,0 % estaban solteras y el 73,4% desempleadas. La principal causa de interrupción fue el riesgo para la salud de la madre en el 61,0 %, seguido por antecedente de violencia sexual en el 26,4 % y malformaciones fetales en el 12,6 %; un total de 70 mujeres (80,4 %) tenía menos de 18 semanas de gestación y fueron tratadas con misoprostol más aspiración manual endouterina; 17 (19,6%) tenían entre 18 y 26 semanas de gestación, las cuales recibieron misoprostol y legrado. El primer grupo (edad gestacional <18 semanas) no presentó complicaciones, solo efectos no deseados tales como dolor y vómito; el segundo grupo (> o igual a 18 semanas) presentó hemorragia en el 41 % de los casos. CONCLUSIONES: el riesgo para la salud materna constituyó el principal motivo para la interrupción del embarazo. La interrupción del embarazo antes de la semana 18 es segura, entre las semanas 18 a 26, con misoprostol y legrado uterino, se acompañó de una alta frecuencia de hemorragia.

Hybrids of Cinchona Alkaloids and Bile Acids as Antiparasitic Agents Against Trypanosoma cruzi.

The current chemotherapy of Chagas disease needs to be urgently improved. With this aim, a series of 16 hybrids of Cinchona alkaloids and bile acids were prepared by functionalization at position C-2 of the quinoline nucleus by a radical attack of a norcholane substituent via a Barton-Zard decarboxylation reaction. The antitrypanosomal activity of the hybrids was tested on different stages and strains of T. cruzi. In particular, eight out of 16 hybrids presented an IC50 ≤1 µg/mL against trypomastigotes of the CL Brener strain and/or a selectivity index higher than 10. These promising hybrids yielded similar results when tested on trypomastigotes from the RA strain of T. cruzi (discrete typing unit-DTU-VI). Surprisingly, trypomastigotes of the Y strain (DTU II) were more resistant to benznidazole and to most of the hybrids than those of the CL Brener and RA strains. However, the peracetylated and non-acetylated forms of the cinchonine/chenodeoxycholic bile acid conjugate 4f and 5f were the most trypanocidal hybrids against Y strain trypomastigotes, with IC50 values of 0.5 and 0.65 µg/mL, respectively. More importantly, promising results were observed in invasion assays using the Y strain, where hybrids 5f and 4f induced a significant reduction in intracellular amastigotes and on the release of trypomastigotes from infected cells.

Safety of the treatment for voluntary pregnancy termination by gestational age. Medellín, Colombia, 2013-2014 / Seguridad del tratamiento de la interrupción voluntaria del embarazo según edad gestacional en medellín, colombia, 2013-2014

RESUMEN Objetivo: describir la seguridad del tratamiento médico-quirúrgico empleado en mujeres que acuden a interrupción voluntaria del embarazo. Materiales y métodos: cohorte histórica. Se incluyeron todas las mujeres embarazadas, hasta con 26 semanas de edad gestacional, a quienes se les dio tratamiento para interrupción voluntaria del embarazo en una institución de referencia en Medellín, Colombia, entre enero de 2013 y diciembre de 2014. Muestreo consecutivo. Se midieron las variables sociodemográficas obstétricas, los efectos no deseados y las complicaciones en el tratamiento de la interrupción voluntaria del embarazo. Se hizo análisis descriptivo. Resultados: se incluyeron 87 mujeres, la mediana de edad de las mujeres al momento de la interrupción fue de 24 años (rango intercuartílico [Rq] = 12), el 69,0 % estaban solteras y el 73,4 % desempleadas. La principal causa de interrupción fue el riesgo para la salud de la madre en el 61,0 %, seguido por antecedente de violencia sexual en el 26,4 % y malformaciones fetales en el 12,6 %; un total de 70 mujeres (80,4 %) tenía menos de 18 semanas de gestación y fueron tratadas con misoprostol más aspiración manual endouterina; 17 (19,6 %) tenían entre 18 y 26 semanas de gestación, las cuales recibieron misoprostol y legrado. El primer grupo (edad gestacional <18 semanas) no presentó complicaciones, solo efectos no deseados tales como dolor y vómito; el segundo grupo (> o igual a 18 semanas) presentó hemorragia en el 41 % de los casos. Conclusiones: el riesgo para la salud materna constituyó el principal motivo para la interrupción del embarazo. La interrupción del embarazo antes de la semana 18 es segura, entre las semanas 18 a 26, con misoprostol y legrado uterino, se acompañó de una alta frecuencia de hemorragia.

ABSTRACT Objective: To describe the safety of medical and surgical treatments used in women seeking voluntary pregnancy termination. Materials and Methods: Historical cohort of all pregnant women with up to 26 weeks of gestation who received treatment for voluntary pregnancy termination in a referral institution in Medellín, Colombia, between January 2013 and December 2014. Sampling was consecutive. Measured variables included sociodemographic and obstetric variables, undesired effects, and complications of the voluntary pregnancy termination treatment. A descriptive analysis was carried out. Results: Overall, 87 women were included. The mean age at the time of termination was 24 years (inter-quartile range [IQR] = 12), 69.0 % were single, and 73,4 % were unemployed. The main reason for termination was the risk to the mother's health in 61,0 % of cases, followed by a history of sexual violence in 26.4 % and fetal malformations in 12.6 %; a total of 70 women (80,4 %) had less than 18 weeks of gestation and were treated with misoprostol plus manual vacuum aspiration; 17 (19,6 %) had between 18 and 26 weeks of gestation and were treated with misoprostol followed by dilation and curettage. The first group (gestational age <18 weeks) experienced undesired effects such as pain and vomiting; in the second group (> or equal to 18 weeks), 41.0 % of the women experienced hemorrhage. Conclusions: The risk to the mother's health was the main reason for the termination of pregnancy. Termination before 18 weeks was found to be safe, while termination between 18 and 26 weeks using misoprostol and curettage was associated with a high frequency of hemorrhage.

Salud mental en Colombia. Un análisis crítico / Mental health in Colombia. A critical analysis

Resumen Introducción: La Organización Mundial de la Salud declaró la importancia de la salud mental y estableció la necesidad de promover el bienestar, la prevención, el tratamiento y la rehabilitación de las personas con trastornos mentales. Colombia adoptó estos lineamientos, pero la crisis de la salud de los últimos años afectó la atención de los pacientes con enfermedad mental. Este estudio indaga aspectos históricos frente a la salud mental en Colombia, las principales limitaciones al actual sistema y las estrategias que podrían implementarse. Método: Búsqueda en bases de datos bibliográficos de artículos enfocados en la normatividad e implementación de políticas públicas de salud mental en Colombia. Resultados: Se han hecho importantes esfuerzos por promulgar leyes y políticas que acaben las brechas para el diagnóstico y el tratamiento y transformar la realidad de los colombianos que sufren trastornos mentales. Conclusión: La salud mental continúa siendo la cenicienta en las políticas públicas. Es evidente la falta de coherencia entre lo que se propone y lo que ocurre por la inadecuada implementación e interpretación de las normas. La normatividad en salud mental no ha logrado cumplir sus objetivos, lo cual hace que la atención en salud mental en Colombia aun sea muy deficiente.

Abstract Introduction: The World Health Organization declared the importance of mental health and established the need to promote the welfare, prevention, treatment and rehabilitation of people with mental disorders. Although these guidelines were adopted in Colombia, the health crisis of recent years affected the care of patients with mental illness. This study seeks to investigate historical aspects of mental health in Colombia, the main limitations to the current system and the strategies that could be implemented. Method: Search in bibliographic databases of articles focused on the regulation and implementation of public mental health policies in Colombia. Results: In Colombia, significant efforts have been made to enact mental health laws and policies that overcome the gaps in diagnosis and treatment and transform the reality of Colombians suffering from mental disorders. Conclusion: Despite the attempts, mental health continues to be ashen in public policies. It is evident the lack of coherence between what is proposed and what happens due to the inadequate implementation and interpretation of the norms. Mental health regulations have not met their objectives, which means that mental health care in Colombia is still very poor.

Ciberacoso y comportamiento suicida. ¿Cuál es la conexión? A propósito de un caso / Cyberbullying and Suicidal Behavior: What is the Connection? About a Case

Resumen Introducción: La victimización a través de las redes sociales se ha asociado con problemas de salud mental como depresión y comportamiento suicida. Objetivo: Presentar el caso clínico de una adolescente víctima de cyberbullying con síntomas depresivos y comportamiento suicida. Metodología: Reporte de caso y revisión no sistemática de la literatura relevante. Resultados: Se presenta un reporte de caso, tratado en un hospital de Medellín debido a dos intentos de suicidio relacionados con las redes sociales. Discusión: En la actualidad, existen múltiples recursos de los medios sociales. El advenimiento de Internet y teléfonos inteligentes no es solo una estrategia para mejorar las interacciones sociales, sino que también contribuye a deteriorar la salud mental de algunas personas jóvenes vulnerables. Conclusión: Este caso nos sensibiliza sobre la relación entre el crecimiento de redes sociales y el acoso cibernético. No podemos establecer la causalidad, pero podríamos deducir que algunos contenidos en la web podrían propiciar un mayor riesgo de enfermedad mental para los jóvenes que están expuestos y vulnerables.

Abstract Introduction: Social networks have increased in recent decades, and with them the bullying, causing difficulties in young people's mental health expressed through depressive symptoms, suicidal ideation and suicide attempts. Up next, we present a case that exemplifies this situation. Objective: To describe a case report that exemplifies this new outlook in young people and how it affects their mental health. Methodology: Case report and non-systematic literature review. Results: One case report, treated at a hospital in Medellin due to two suicide attempts related to social networks is presented. Discussion: Currently, there are multiple social media resources, the advent of internet and smartphones is not only a strategy for improving social interactions, but it also contributes to impair mental health of some vulnerable young people. Conclusion: This case sensitize us, about the relationship between the growing social networking and cyberbullying as well as suicidal thoughts / attempts; thanks to this case and the available literature, we can't establish causality but we could deduce that the internet utter a increased risk for young people who are exposed and more vulnerable.

[Cyberbullying and Suicidal Behavior: What is the Connection? About a Case]. / Ciberacoso y comportamiento suicida. ¿Cuál es la conexión? A propósito de un caso.

INTRODUCTION: Social networks have increased in recent decades, and with them the bullying, causing difficulties in young people's mental health expressed through depressive symptoms, suicidal ideation and suicide attempts. Up next, we present a case that exemplifies this situation. OBJECTIVE: To describe a case report that exemplifies this new outlook in young people and how it affects their mental health. METHODOLOGY: Case report and non-systematic literature review. RESULTS: One case report, treated at a hospital in Medellin due to two suicide attempts related to social networks is presented. DISCUSSION: Currently, there are multiple social media resources, the advent of internet and smartphones is not only a strategy for improving social interactions, but it also contributes to impair mental health of some vulnerable young people. CONCLUSION: This case sensitize us, about the relationship between the growing social networking and cyberbullying as well as suicidal thoughts / attempts; thanks to this case and the available literature, we can't establish causality but we could deduce that the internet utter a increased risk for young people who are exposed and more vulnerable.

Factors associated with cessation of smoking among Swiss adults between 1991 and 2011: results from the SAPALDIA cohort.

INTRODUCTION: Smoking is still the most preventable cause of disease and premature death in Switzerland, as elsewhere. We aimed to assess the main determinants of smoking cessation in the population-based cohort of SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). METHODS: The SAPALDIA study was initiated in 1991 with 9651 participants aged 18 to 60 years from eight areas (S1). Follow-up assessments were conducted in 2002 (S2; 8047 participants) and 2010/11 (S3; 6088 participants). At each survey, detailed information on health and potential health-related factors was collected and lung function measured. Using logistic regression, we assessed predictors of smoking cessation between S1 and S2 and between S2 and S3. RESULTS: In both periods, highest educational level (summary odds ratio [OR] 1.49, 95% confidence interval [CI] 1.08-2.06; ref. lowest level), FEV1/FVC <0.5 (OR 6.19, 95% CI 2.44-15.7, ref. FEV1/FVC ≥0.7), higher age in men (OR 1.02, 95% CI 1.01-1.03, per year) and overweight (OR 1.38, 95% CI 1.16-1.64) were significant predictors of smoking cessation. Nicotine dependence (OR 0.97, 95% CI 0.96-0.98, per cigarette smoked a day) and female sex between age 45 and 60 (e.g., OR 0.74, 95% CI 0.61-0.91, at age 50) were negatively associated with smoking cessation. Moreover, smokers at S2 reporting a diagnosis of depression were less likely to quit smoking by S3 (OR 0.53, 95% CI 0.30-0.93). CONCLUSIONS: Prospective tobacco control policies in Switzerland should be addressed to women, younger persons and persons of lower education.

Socio-demographic, psychiatric and legal characterisation of Colombian unimputable patients, 2000-2013, / Caracterización sociodemográfica, psiquiátrica y legal de pacientes inimputables de Colombia, 2000-2013

Abstract Introduction: Mental illness has been associated with violent behaviour. Criminal behaviour in the mentally ill population in Colombia has not been well studied. Methods: This is a retrospective, descriptive study, from a secondary source. An analysis was made of the sociodemographic, clinical, and legal variables of 127 unfit to plead patients. A descriptive analysis of quantitative variables was performed by measures of central tendency, and frequencies and percentages were calculated for the qualitative variables. The software SPSS® version 21.0 was used to analyse the data, and the study was approved by the Research Committee of the CES University. Results: The median age was 34 years, interquartile range 19 years, and 92.1% were men. The primary diagnosis was schizophrenia in 63%, 66.9% consumed alcohol, and 58.3% other drugs at the time they committed the crime. Almost one/third (29.1%) had a criminal record, and the most common type of crime was murder in 44.1% of cases. Around half (50.3%) of the victims had some degree of consanguinity with the patient. Discussion: The study subjects had higher illiteracy and lower educational levels than the Colombian prison population. Schizophrenia was the main diagnosis, and homicide the most prevalent crime, which agrees with the literature where non-indictable patients are responsible for 5-20% of murder cases worldwide. Conclusions: To reduce the gap between the diagnosis and treatment of mental disorders, especially schizophrenia, should be within the specific actions to prevent violence and criminal behaviour associated with mental illness.

Resumen Introducción: La enfermedad mental se ha asociado con comportamientos violentos. En Colombia poco se ha estudiado la población de enfermos mentales con comportamiento criminal. Métodos: Estudio descriptivo retrospectivo a partir de fuente secundaria. Se analizaron variables sociodemográficas, clínicas y legales de 127 pacientes inimputables. Se realizó análisis descriptivo de las variables cuantitativas a través de medidas de tendencia central, y para las variables cualitativas se obtuvieron frecuencias y porcentajes. La información se analizó con el software SPSS versión 21.0. La investigación fue aprobada por el Comité de Investigación de la Universidad CES. Resultados: La mediana de edad fue 34 [intervalo intercuartílico, 19] años; el 92,1% eran varones. El diagnóstico principal fue esquizofrenia en el 63%. En el momento de cometer el crimen, el 66,9% consumía alcohol y el 58,3%, drogas. El 29,1% tenía antecedentes delictivos y el tipo de delito más frecuente (44,1%) fue el homicidio. El 50,3% de las víctimas tenían algún grado de consanguinidad con el paciente. Discusión: En los sujetos del estudio había más analfabetismo y menor nivel educativo que en la población general carcelaria colombiana. La esquizofrenia fue el principal diagnóstico y el homicidio, el delito más prevalente, lo cual coincide con la literatura que refleja que los inimputables son responsables de un 5-20% de los casos de homicidio en el mundo. Conclusiones: Disminuir la brecha para el diagnóstico y el tratamiento de los trastornos mentales, especialmente la esquizofrenia, estaría entre las acciones concretas para prevenir la violencia y la conducta criminal asociada a enfermedad mental.