Vértigo en gestantes: presentación clínica, impacto en la calidad de vida y factores asociados / Vertigo in pregnancy: clinical presentation, impact on quality of life and associated factors

OBJETIVO: Evaluar las características clínicas, el impacto en la calidad de vida y los factores asociados con vértigo en gestantes hospitalizadas en una institución de alta complejidad. MÉTODO: Estudio transversal. Se realizó una encuesta dirigida a la presencia de vértigo y sus características clínicas en 2020-2021. La calidad de vida se evaluó con el cuestionario Dizziness Handicap Inventory (DHI). El análisis estadístico incluyó un modelo lineal generalizado. RESULTADOS: De 103 mujeres, el 19,4% indicaron vértigo principalmente en el segundo trimestre de gestación (60%), con una mediana de 3,5 (rango intercuartil: 1,5-7,5) episodios. Fueron referidos vértigos episódicos asociados con cambios posicionales (40%), acompañados de inestabilidad (60%), cefalea (60%), fotopsias (55%) y tinnitus (45%). Las mujeres con vértigo presentaron mayor frecuencia de discapacidad moderada a grave en las dimensiones del DHI emocional (30 vs. 2,4%; p = 0,001), funcional (40 vs. 2,4%; p < 0,001) y física (55 vs. 2,4%; p < 0,001) en comparación con las mujeres sin la patología. La hospitalización durante el embarazo Razón de proporción (RP): 4,02; intervalo de confianza del 95% [IC95%]: 1,64-9,85; p = 0,002) y la presencia de vértigo pregestacional (RP: 2,37; IC95%: 1,15-4,88; p = 0,019) se identificaron como factores asociados. CONCLUSIONES: La alta frecuencia de vértigo en las gestantes sugiere la importancia de estudiar esta condición durante el embarazo, para lograr un manejo integral y generar acciones de prevención y control efectivas.

OBJECTIVE: To evaluate clinical characteristics, impact on quality of life and factors associated with vertigo in pregnant women hospitalized in a highly complex institution. METHOD: A cross-sectional study was conducted in 2021-2022. One focused survey including Dizziness Handicap Inventory (DHI) was performed. The statistical analysis was performed using a generalized lineal regression. RESULTS: 103 patients were included, 19.4% indicated vertigo mostly during the second semester (60%). A median of 3.5 episodes was obtained (RIC: 1.5-7.5). Positional and episodic vertigos (40%) associated with unsteadiness (60%), headache (60%), photopsia (55%) and tinnitus (45%) were described. DHI in pregnant females with vertigo compared to those without vertigo, presented higher rates of moderate to severe disability in the emotional (30 vs. 2.4%: p = 0.001), functional (40 vs. 2.4%; p < 0.001) and physical (55 vs. 2.4%; p < 0.001) dimensions. Hospitalizations during the pregnancy (RP: 4.02; 95%CI: 1.64-9.85; p = 0.002) and previous episodes before pregnancy (RP: 2.37; 95%CI: 1.15-4.88; p = 0.019) were identified as associated factors with current vertigo episodes. CONCLUSIONS: The high frequency of vertigo in pregnant women suggests the importance of studying this condition during pregnancy, to achieve comprehensive management and generate effective prevention and control actions.

A realist evaluation of a support and training program for family caregivers in the municipality of Envigado: A research protocol.

AIMS: In Envigado, Colombia, the Secretariat of Health has implemented, since 2011, an interprofessional program involving nurses to support and train relatives to improve the quality of life of people with a loss of autonomy and their family caregivers. The objectives of this study are to assess the outcomes of this program and to explore the contextual elements and mechanisms that can explain these outcomes. DESIGN: This article presents the research protocol for a realist evaluation that will be carried out to gather the perspectives of various local stakeholders involved. METHODS: Four outcomes on family caregivers will be measured quantitatively using self-administered questionnaires and numerical scales. Contextual elements and mechanisms will then be explored qualitatively through focus groups and individual interviews. An iterative analysis will enable the refinement of a program theory. RESULTS: The results will inform a program theory that underlies the outcomes of the family caregiver support and training program. PATIENT OR PUBLIC CONTRIBUTION: Community stakeholders, family caregivers, people with a loss of autonomy and their relatives will be involved in data collection and/or in the validation of the program theory.

Etiología de las infecciones de transmisión sexual (ITS) diagnosticadas por la técnica de PCR múltiple-hibridación en población colombiana de la ciudad de Medellín atendida en el Laboratorio Clínico VID / Etiology of sexually transmitted infections (STIs) diagnosed by multiplex PCR-hibridization assay technique in a Colombian population attending the VID Clinical Laboratory in Medellin

Introducción. Las infecciones de transmisión sexual (ITS) son y seguirán siendo un serio problema de salud pública en todo el mundo según los datos de la OMS, con el agravante que la mayoría de los casos son asintomáticos y, además, no existe otro reservorio distinto al humano. El diagnóstico se puede realizar con pruebas tradicionales y moleculares, estas últimas incluyen la reacción en cadena de la polimerasa (PCR), de las cuales existen varios tipos, entre ellas, la PCR múltiple que tiene la capacidad de detectar ITS polimicrobianas a partir de una sola muestra. El objetivo de este estudio fue establecer cuáles fueron las infecciones de transmisión sexual más frecuentes en diferentes grupos de pacientes, así como determinar la utilidad del uso de la técnica de PCR múltiple en el diagnóstico de las ITS. Metodología. Se trata de un estudio observacional de corte transversal realizado entre los años 2021 y 2022 con pacientes que acudieron al servicio de diagnóstico del Laboratorio Clínico VID por sospecha de ITS. Las muestras recolectadas fueron evaluadas utilizando una prueba comercial basada en la técnica de PCR múltiple e hibridación. Las muestras procesadas fueron: orina e hisopados de endocérvix, uretra, recto, faringe y úlceras. Resultados. Se estudiaron 1.027 pacientes, de estos, 228 (22,2 %) fueron positivos para diferentes agentes de trasmisión sexual, distribuidos así: 50 (21,9 %) mujeres, 129 (56,6 %) hombres heterosexuales y 49 (21,5 %) hombres que tenían sexo con hombres (HSH). La edad promedio de las mujeres fue 30 años, y la de ambos grupos de hombres fue 36 años. Los microorganismos más frecuentemente identificados en mujeres fueron: C. trachomatis (A-K) en 28,6 %, seguido de virus herpes simplex tipo 2 (VHS-2) en 26,8 % y N. gonorrhoeae en 17,9 %. En hombres heterosexuales fueron C. trachomatis (A-K) en 37,5 %, N. gonorrhoeae en 21,5 % y VHS-2 en 18,7 %. En HSH fueron C. trachomatis (L1-L3) en 32,7 %, seguido de N. gonorrhoeae en 27,6 %, y de C. trachomatis (A-K) y VHS-2, ambos en 13,8 %. En 11 hombres heterosexuales, 8 HSH y en 6 mujeres, se identificó infección polimicrobiana. Conclusiones. C. trachomatis (A-K) fue el microorganismo más prevalente causante de ITS, seguido de N. gonorrhoeae en ambos grupos de hombres, y de VHS-2 en las mujeres, muy similar a lo reportado a nivel mundial. La prueba de PCR múltiple permite la detección de infecciones polimicrobianas comúnmente asociadas a ITS y el diagnóstico es preciso y confiable, incluso en pacientes asintomáticos

Sexually transmitted infections (STIs) are and will continue to be a serious public health problem throughout the world according to WHO data, with the aggravating factor that most cases are asymptomatic and, furthermore, there is no other reservoir other than humans. The diagnosis can be made with traditional and molecular tests, the latter include the polymerase chain reaction (PCR), of which there are several types, among them, multiplex PCR that has the capacity to detect polymicrobial STIs from a single sample. The objective of this study was to establish which were the most frequent sexually transmitted infections in different groups of patients, as well as to determine the usefulness of the multiplex PCR technique in the diagnosis of STIs. Methodology. This is an observational, cross-sectional study carried out between 2021 and 2022 with patients who attended the VID Clinical Laboratory for suspected STIs. The collected samples were evaluated using a commercial test based on the multiplex PCR technique and hybridization. The samples processed were: urine and swabs from endocervix, urethra, rectum, pharynx, and ulcers. Results. The study included 1,027 patients, of these, 228 (22.2%) were positive for different sexually transmitted agents, distributed as follows: 50 (21.9%) women, 129 (56.6%) heterosexual men and 49 (21.5%) men who had sex with men (MSM). The average age of the women was 30 years, and that of both groups of men was 36 years. The microorganisms most frequently identified in women were: C. trachomatis (A-K) in 28.6%, followed by herpes simplex virus type 2 (HSV-2) in 26.8% and N. gonorrhoeae in 17.9%. In heterosexual men they were C. trachomatis (A-K) in 37.5%, N. gonorrhoeae in 21.5% and HSV-2 in 18.7%. In MSM they were C. trachomatis (L1-L3) in 32.7%, followed by N. gonorrhoeae in 27.6%, and C. trachomatis (A-K) and HSV-2, both in 13.8%. Polymicrobial infection was identified in 11 heterosexual men, 8 MSM, and 6 women. Conclusions. C. trachomatis (A-K) was the most prevalent STI-causing microorganism, followed by N. gonorrhoeae in both groups of men, and HSV-2 in women, very similar to that reported worldwide. The multiplex PCR test allows the detection of polymicrobial infections commonly associated with STIs and the diagnosis is accurate and reliable, even in asymptomatic patients

Vertigo in Pregnancy: A Narrative Review.

During pregnancy, physical, hormonal, and psychological changes may occur from conception to labor. Balance is also impacted throughout this time, leading to symptoms such as vertigo and unsteadiness. These symptoms may appear at any time and can cause disability and physical impairment. Little has been published about vertigo in pregnancy. We performed a narrative review of vertigo in pregnant patients. Vertigo in pregnant females may be associated with hormonal changes in peripheral structures and inner ear organs. Meniere's disease, vestibular migraine, and benign paroxysmal positional vertigo are usually exacerbated during pregnancy. Specific changes to hearing and proprioception in the physical examination are also noted between the second and third trimester of pregnancy. These symptoms are usually seen in pregnant patients throughout this time. Some types of vertigo may be exacerbated and others may present at any time of pregnancy. Further research is needed to understand the clinical and pathological association of audiovestibular symptoms during pregnancy.

Prevalencia y factores asociados al trastorno de estrés postraumático en personas desplazadas en Colombia / Prevalence and factors associated with post-traumatic stress disorder in displaced persons in Colombia

Resumen Introducción: el trastorno por estrés postraumático (TEPT) es un síndrome que sobreviene después de que una persona experimenta un acontecimiento traumático extremo como la violencia en sus diversas manifestaciones: doméstica, sexual, política o armada. Objetivo: determinar la prevalencia del TEPT, los factores demográficos y las condiciones del desplazamiento asociadas en población desplazada por la violencia producto del conflicto armado, en tres ciudades de Colombia: Bogotá, Medellín y Buenaventura. Método: estudio observacional, analítico con diseño cross-sectional, medición transversal, mediante disponibilidad de datos retrospectivos. La población objeto de estudio se compone de 1 026 registros de personas víctimas del conflicto armado, con edades entre 13 y 65 años, participantes del estudio primario "Salud mental en víctimas de desplazamiento forzado por la violencia en Colombia. El caso de Bogotá, Medellín y Buenaventura". Resultados: la prevalencia de vida del TEPT es de 9,9 %, siendo superior en la ciudad de Buenaventura; el trastorno presenta una asociación estadísticamente significativa con variables como la ocupación, el estado civil y la forma como se llevó a cabo el desplazamiento. Conclusiones: resaltan aspectos como la falta de ocupación, las características del desplazamiento y el bajo apoyo social como posibles factores que desencadenan o intensifican el TEPT.

Abstract Introduction: post-traumatic stress disorder (PTSD) is a syndrome that occurs after a person experiences an extreme traumatic event such as violence in its various manifestations: domestic, sexual, political, or armed. Objective: to determine the prevalence of PTSD and the demographic factors and associated displacement conditions in the population displaced by the violence resulting from the armed conflict, in three cities of Colombia: Bogotá, Medellín and Buenaventura. Method: observational, analytical study with cross-sectional design, cross-sectional measurement, through availability of retrospective data. The population under study consists of 1,026 records of people who are victims of the armed conflict, aged between 13 and 65 years, participants in the primary study "Mental disorders in displaced population victims of the armed conflict, in three cities of Colombia". Results: the lifetime prevalence of PTSD is 9.9%, higher in the city of Buenaventura; the disorder presents a statistically significant association with variables such as occupation, marital status, and the way in which the displacement occurred. Conclusions: aspects such as lack of job, displacement characteristics and low social support stand out as possible factors that trigger or intensify PTSD.

Cohesión familiar y factores relacionados en adolescentes escolarizados / Family cohesion and related factors in school adolescents

Resumen Introducción: El nivel de cohesión de un núcleo familiar permite caracterizar los vínculos y relaciones que existen entre sus miembros y constituye un insumo fundamental para el desarrollo de políticas y programas de intervención en la familia. Objetivo: Identificar factores asociados a la cohesión familiar en adolescentes del Municipio de Envigado. Materiales y métodos: Estudio transversal, de fuente de información primaria, con una muestra de 1008 estudiantes de dos colegios de Envigado. Se utilizó la escala de cohesión familiar, de Depresión de Zung, de Habilidades Sociales de Gismero, y preguntas sociodemográficas y de consumo de sustancias. Resultados: El 61,5% de los adolescentes se encontraban sin riesgo de alcoholismo, el 73,8% sin dependencia a drogas, un 16,5% tenían riesgo de depresión y un 81,7% presentaban buenas habilidades sociales. La prevalencia de cohesión familiar fue 96,6%. La satisfacción con la familia y la ausencia de depresión, se asociaron a buena cohesión familiar. Conclusiones: La presencia de depresión en el adolescente y un alto nivel de insatisfacción con el núcleo familiar son factores asociados a la falta de cohesión familiar; factores como la violencia intrafamiliar, las habilidades sociales y el consumo de sustancias psicoactivas no presentaron asociación con la variable de interés.

Abstract Introduction: The level of cohesion within a family nucleus is useful to characterize connections and relationships established between its members. It also constitutes a fundamental factor in the development of family intervention programs and policies. Objective: To identify factors associated with family cohesion in adolescents from the municipality of Envigado (Colombia). Materials and methods: A cross-sectional study using a primary source of information and a sample of 1008 students from two schools from Envigado. The following instruments were used: family cohesion scale; Zung's Depression scale; Gismero's Social Skills scale; and sociodemographic and substance use questions. Results: 61.5% of adolescents were not at risk for alcoholism, 73.8% were not drug dependent, 16.5% were at risk of depression, and 81.7% had adequate social skills. The prevalence of family cohesion was 96.6%. A feeling of satisfaction with their families and absence of depression were associated with good family cohesion. Conclusions: Depression in adolescents and a high level of dissatisfaction towards their family are factors associated with the lack of family cohesion. Factors such as domestic violence, social skills, and use of psychoactive substances did not show an association with the variable of interest.

El diagnóstico de Infecciones de Transmisión Sexual por la técnica de biología molecular es la mejor estrategia para su diagnóstico oportuno y específico. Un caso clínico / The diagnosis of Sexually Transmitted Infections by the molecular biology technique is the best strategy for its timely and specific diagnosis. A clinical case

Resumen Se presenta el caso de un paciente a quien se le diagnosticó una Infección de Transmisión Sexual (ITS) por la técnica de PCR múltiple y en quién se logró por esta técnica, detectar cuatro agentes diferentes simultáneamente: Neisseria gonorreae, Mycoplasma hominis, Ureaplasma urealyticum/parvum y Trichomonas vaginalis, situación esta, que no hubiera sido posible utilizando el procedimiento estándar.

Summary Here we report the case of a patient with a Sexually Transmitted Disease (STI) in whom four different agents were detected by a multiple PCR technique: Neisseria gonorreae, Mycoplasma hominis, Ureaplasma urealyticum / parvum and Trichomonas vaginalis. This detection of multiple agents would not have been possible using conventional procedures.

Molecular diagnosis of meningitis and meningoencephalitis with an automated real-time multiplex polymerase chain reaction in a tertiary reference complex in Medellín, Colombia.

Meningoencephalitis is a syndrome of multiple etiologies associated with important morbidity and mortality. It may be caused by various infectious agents (viruses, bacteria, parasites and fungi). Establishing the etiology of meningoencephalitis is crucial for early and specific treatment. Molecular assays such as the multiplex polymerase chain reaction (PCR) offer an alternative in diagnosing central nervous system infections. This study aimed to describe the performance of an automated multiplex molecular test from patients with suspected meningitis and meningoencephalitis in a tertiary referral complex in Medellin, Colombia. Thus, a prospective study was performed in 638 cerebrospinal fluid samples from January 2017 to July 2019. Molecular detections were carried out by means of the FilmArray® Meningitis/Encephalitis (M/E) Panel from bioMérieux, France, and by conventional tests. Univariate analyses for microbiological and demographic characteristics were performed. Accuracy of the bacterial/fungal PCR assay compared to cultures was also performed. Among patients, 57.7% were male, the median age was 24 (IQR: 6 - 47) years old. The overall positivity was 15.2% (97 detections) and viruses were detected in 45.5% of the samples, bacteria in 43.5% and fungi in 10.8%. The most frequent etiological agents were: Streptococcus pneumoniae (16%), Cryptococcus neoformans/gatti (11.3%) and Herpes simplex virus (10.3%). Four double detections were found. Almost half of positive detections were in patients under 15 years old. This molecular approach is reliable and easily implantable into a laboratory routine, increasing the capacity of detection of bacterial and viral causative agents of meningitis, possibly playing a relevant role in the clinical context.

Factors Associated With Suicidal Ideation in Older Adults From Three Cities in Colombia, 2016. / Factores asociados con la ideación suicida del adulto mayor en tres ciudades de Colombia, 2016.

INTRODUCTION: Suicidal ideation refers to thoughts that range from a vague idea of committing suicide to a specific suicide plan. OBJECTIVE: To explore factors such as demographic, social, family, abuse, risk of depression, habits and health conditions, which influence suicidal ideation in the elderly people in the cities of Medellín, Barranquilla, and Pasto (Colombia), with the intention to identify those associated factors that can be used in public health programs focused on this population. METHODS: Cross-sectional analytical study was conducted using a secondary source, demographic, social, clinical variables, social support, discrimination, abuse, happiness, depression, functional capacity, and as a dependent variable were asked the question: "Have you ever thought about committing suicide?" A descriptive, bivariate and multivariate analysis was performed. RESULTS: The median age was ≤ 69 [interquartile range, 11] years, and 58.2% were women. The prevalence of suicidal ideation was 6.4%, and of these, 28.7% had made plans to end their lives, and 66.7% had tried at least once. A statistical association was found with informal employment, cigarette consumption, alcohol and psychoactive substances, risk of depression, having a disability, dissatisfaction with their quality of life, with their health, with their economic situation, as well as feeling unhappy, bad treatment and bad relationships among family members, poor social support, sexual and economic abuse, and finally, discrimination. CONCLUSIONS: Suicidal ideation in older adults in three cities of Colombia is explained by the sexual and economic abuse that this population is suffering, as well as bad personal relationships between the members of the family of the older adult. The risk of depression increases the probability of having thoughts against one's life.

Factores asociados con la ideación suicida del adulto mayor en tres ciudades de Colombia, 2016 / Factors Associated With Suicidal Ideation in Older Adults From Three Cities in Colombia, 2016

RESUMEN Introducción: La ideación suicida se refiere a pensamientos que abarcan desde una vaga idea de suicidarse a un plan específico de suicidio. Objetivo: Explorar factores demográficos, sociales y familiares, maltrato, riesgo de depresión y hábitos y condiciones de salud que influyen en la ideación suicida del adulto mayor en las ciudades de Medellín, Barranquilla y Pasto, para identificar aquellos en los que se puede intervenir con programas de salud pública enfocados en esta población. Métodos: Estudio analítico transversal con fuente secundaria; se consideraron variables demográficas, sociales y clínicas, apoyo social, discriminación, maltrato, felicidad, depresión y capacidad funcional, y como variable dependiente, la pregunta: «¿ha pensado en atentar contra su vida?¼. Se realizaron análisis descriptivo, bivariable y multivariable. Resultados: La mediana de edad fue ≤ 69 (intervalo intercuartílico, 11) años; el 58,2% eran mujeres; la prevalencia de ideación suicida fue del 6,4%; el 28,7% de estos había hecho planes para terminar con su vida y el 66,7% lo había intentado al menos una vez. Se encontró asociación estadística con el empleo informal, el consumo de cigarrillos, alcohol y sustancias psicoactivas, el riesgo de depresión, tener discapacidad, la insatisfacción con la calidad de vida, la salud y la situación económica, sentirse infeliz, los maltratos y las malas relaciones entre los miembros de la familia, el escaso apoyo social, el maltrato sexual y económico y, por último, la discriminación. Conclusiones: La ideación suicida de los adultos mayores en 3 ciudades de Colombia se explica por el maltrato sexual y económico que sufre esta población; asimismo las malas relaciones personales entre los miembros de la familia del adulto mayor y el riesgo de depresión aumentan la probabilidad de que se presenten pensamientos contra la propia vida.

ABSTRACT Introduction: Suicidal ideation refers to thoughts that range from a vague idea of committing suicide to a specific suicide plan. Objective: To explore factors such as demographic, social, family, abuse, risk of depression, habits and health conditions, which influence suicidal ideation in the elderly people in the cities of Medellín, Barranquilla, and Pasto (Colombia), with the intention to identify those associated factors that can be used in public health programs focused on this population. Methods: Cross-sectional analytical study was conducted using a secondary source, demographic, social, clinical variables, social support, discrimination, abuse, happiness, depression, functional capacity, and as a dependent variable were asked the question: "Have you ever thought about committing suicide?" A descriptive, bivariate and multivariate analysis was performed. Results: The median age was ≤ 69 [interquartile range, 11] years, and 58.2% were women. The prevalence of suicidal ideation was 6.4%, and of these, 28.7% had made plans to end their lives, and 66.7% had tried at least once. A statistical association was found with informal employment, cigarette consumption, alcohol and psychoactive substances, risk of depression, having a disability, dissatisfaction with their quality of life, with their health, with their economic situation, as well as feeling unhappy, bad treatment and bad relationships among family members, poor social support, sexual and economic abuse, and finally, discrimination. Conclusions: Suicidal ideation in older adults in three cities of Colombia is explained by the sexual and economic abuse that this population is suffering, as well as bad personal relationships between the members of the family of the older adult. The risk of depression increases the probability of having thoughts against one's life.

Women's reluctance for pregnancy: Experiences and perceptions of Zika virus in Medellin, Colombia.

OBJECTIVE: To explore how being infected with the Zika virus during pregnancy was experienced by affected women, and how it influenced their family relationships and future family planning. METHODS: We conducted a qualitative study, including 19 semistructured interviews with women of reproductive age and confirmed Zika infection during 2015-2018 in Medellin, Colombia. Purposeful sampling was applied, and participants were identified through National Public Health Surveillance System records. Interviews were recorded, transcribed verbatim, and analyzed using content analysis with inductive and deductive approaches. RESULTS: Of 19 women interviewed, eight women identified the pregnancy as unexpected and two women had undergone permanent sterilization. Women had mixed views about decision-making related to family planning, and not having an abortion in a future pregnancy was influenced by religious beliefs. Women knew about vector-borne transmission but were not well informed about sexual transmission of the virus. Women desired better support and guidance to ease concerns about Zika virus. CONCLUSION: All interviewed women expressed a need for more information about Zika virus and continuous support, specifically after delivery, from healthcare professionals. Communication strategies to enhance culturally sensitive messages and for accurate perception of information are recommended during Zika outbreaks.

Factores asociados a la vulnerabilidad cognitiva de los adultos mayores en tres ciudades de Colombia / Factors Associated with the Cognitive Vulnerability of Older Adults in Three Colombian Cities / Fatores associados à vulnerabilidade cognitiva dos idosos em três cidades da Colômbia

RESUMEN Objetivo: identificar los factores asociados a la vulnerabilidad cognitiva de los adultos mayores en tres ciudades de Colombia en el año 2016. Materiales y método: se condujo un estudio cuantitativo, transversal analítico, con fuente de información primaria, encuestando a 1514 adultos mayores residentes en la zona urbana de Barranquilla, Medellín y Pasto, empleando muestreo probabilístico bietápico. La condición cognitiva se evaluó con el Mini Examen Cognoscitivo modificado. Se realizaron análisis univariados, bivariados y multivariados, cálculos estadísticos y epidemiológicos, intervalos de confianza y pruebas estadísticas menores del 5%. Resultados: el riesgo de deterioro cognitivo se presentó en un 5,1% en Medellín, un 2,7% en Pasto y un 1,7% en Barranquilla, predominantemente en hombres, con edades entre los 75 y 89 años, sin pareja y con bajos niveles de escolaridad. El 100% de quienes tenían deterioro cognitivo refieren no realizar actividad física, el 13% reportaron depresión y el 7,7% soporte social escaso. Conclusiones: los factores asociados a la vulnerabilidad cognitiva de los adultos mayores incluyen características demográficas, sociales y de estilos de vida. Es importante considerar estos resultados en las políticas de salud para la población de adultos mayores con el fin de reorientar la atención en la prevención de la vulnerabilidad cognitiva.

ABSTRACT Objective: Identify the factors associated with the cognitive vulnerability of older adults in three Colombian cities during 2016. Materials and methods: A quantitative, cross-sectional, analytical study was conducted with a primary source of information by surveying 1514 older adults living in the urban areas of Barranquilla, Medellín and Pasto. Two-stage probabilistic sampling was used. The cognitive condition of the adults in the sample was evaluated with the modified Mini Cognitive Exam. Univariate, bivariate and multivariate analyzes, statistical and epidemiological calculations, confidence intervals and statistical tests of less than 5% were performed. Results: The risk of cognitive deterioration was found in 5.1% of the sample in Medellín, 2.7% in Pasto and 1.7% in Barranquilla, predominantly among men between 75 and 89 years of age who are without a partner and have low levels of schooling. One hundred percent (100%) of those with cognitive impairment reported having no physical activity, 13% reported depression, and 7.7% indicated social support was scarce. Conclusions: The factors associated with cognitive vulnerability among older adults include demographic, social and lifestyle characteristics. It is important to consider these results when drafting health policies for the elderly population to redirect attention to the prevention of cognitive vulnerability.

RESUMO Objetivo: identificar os fatores associados à vulnerabilidade cognitiva dos idosos em três cidades da Colômbia em 2016. Materiais e método: estudo quantitativo, transversal analítico, com fonte de informação primária, que entrevistou 1514 idosos residentes na zona urbana de Barranquilla, Medellín e Pasto, empregando amostra probabilística bietápica. A condição cognitiva foi avaliada com o Miniexame Cognoscitivo Modificado. Foram realizadas análises univariadas, bivariadas e multivariadas, cálculos estatísticos e epidemiológicos, intervalos de confiabilidade e testes estatísticos menores de 5 %. Resultados: o risco de deterioração cognitiva foi apresentado em 5,1 % em Medellín; 2,7 % em Pasto e 1,7 % em Barranquilla, predominantemente em homens, com faixa etária entre 75 e 89 anos, sem companheiro(a) e com baixo nível de escolaridade. 100 % dos que apresentaram deterioração cognitiva referem não realizar atividade física; 13 % relataram depressão e 7,7 %, apoio social escasso. Conclusão: os fatores associados à vulnerabilidade cognitiva dos idosos incluem características demográficas, sociais e de estilos de vida. É importante considerar os resultados nas políticas de saúde para a população de idosos a fim de reorientar a atenção na prevenção da vulnerabilidade cognitiva.

Simultaneous Top and Bottom Perovskite Interface Engineering by Fullerene Surface Modification of Titanium Dioxide as Electron Transport Layer.

Optimization of the interface between the electron transport layer (ETL) and the hybrid perovskite is crucial to achieve high-performance perovskite solar cell (PSC) devices. Fullerene-based compounds have attracted attention as modifiers on the surface properties of TiO2, the archetypal ETL in regular n-i-p PSCs. However, the partial solubility of fullerenes in the aprotic solvents used for perovskite deposition hinders its application to low-temperature solution-processed PSCs. In this work, we introduce a new method for fullerene modification of TiO2 layers derived from nanoparticles (NPs) inks. Atomic force microscopy characterization reveals that the resulting ETL is a network of TiO2-NPs interconnected by fullerenes. Interestingly, this surface modification enhances the bottom interface of the perovskite by improving the charge transfer as well as the top perovskite interface by reducing surface trap states enhancing the contact with the p-type buffer layer. As a result, rigid PSCs reached a 17.2% power conversion efficiency (PCE), while flexible PSCs exhibited a remarkable stabilized PCE of 12.2% demonstrating the potential application of this approach for further scale-up of PSC devices.

Optimization of the Ag/PCBM interface by a rhodamine interlayer to enhance the efficiency and stability of perovskite solar cells.

Effective control of the interface between the metal cathode and the electron transport layer (ETL) is critical for achieving high performance p-i-n planar heterojunction perovskite solar cells (PSCs). Several organic molecules have been explored as interlayers between the silver (Ag) electrode and the ETL for the improvement in the photovoltaic conversion efficiency (PCE) of p-i-n planar PSCs. However, the role of these organic molecules in the charge transfer at the metal/ETL interface and the chemical degradation processes of PSCs has not yet been fully understood. In this work, we systematically explore the effects of the interfacial modification of the Ag/ETL interface on PSCs using rhodamine 101 as a model molecule. By the insertion of rhodamine 101 as an interlayer between Ag and fullerene derivatives (PC60BM and PC70BM) ETLs improve the PCE as well as the stability of p-i-n planar PSCs. Atomic force microscopy (AFM) characterization reveals that rhodamine passivates the defects at the PCBM layer and reduces the band bending at the PCBM surface. In consequence, charge transfer from the PCBM towards the Ag electrode is enhanced leading to an increased fill factor (FF) resulting in a PCE up to 16.6%. Moreover, rhodamine acts as a permeation barrier hindering the penetration of moisture towards the perovskite layer as well as preventing the chemical interaction of perovskite with the Ag electrode. Interestingly, the work function of the metal cathode remains more stable due to the rhodamine incorporation. Consequently, a better alignment between the quasi-Fermi level of PCBM and the Ag work function is achieved minimizing the energy barrier for charge extraction. This work contributes to reveal the relevance of proper interfacial engineering at the metal-cathode/organic-semiconductor interface.

Self-Functionalization Behind a Solution-Processed NiOx Film Used As Hole Transporting Layer for Efficient Perovskite Solar Cells.

Fabrication of solution-processed perovskite solar cells (PSCs) requires the deposition of high quality films from precursor inks. Frequently, buffer layers of PSCs are formed from dispersions of metal oxide nanoparticles (NPs). Therefore, the development of trustable methods for the preparation of stable colloidal NPs dispersions is crucial. In this work, a novel approach to form very compact semiconducting buffer layers with suitable optoelectronic properties is presented through a self-functionalization process of the nanocrystalline particles by their own amorphous phase and without adding any other inorganic or organic functionalization component or surfactant. Such interconnecting amorphous phase composed by residual nitrate, hydroxide, and sodium ions, proved to be fundamental to reach stable colloidal dispersions and contribute to assemble the separate crystalline nickel oxide NPs in the final film, resulting in a very homogeneous and compact layer. A proposed mechanism behind the great stabilization of the nanoparticles is exposed. At the end, the self-functionalized nickel oxide layer exhibited high optoelectronic properties enabling perovskite p-i-n solar cells as efficient as 16.6% demonstrating the pertinence of the presented strategy to obtain high quality buffer layers processed in solution at room temperature.

[Risky sexual behavior regarding HIV in a college population]. / Las prácticas sexuales de riesgo al VIH en población universitaria.

OBJECTIVE: The study addressed risky sexual behavior regarding HIV infection in students attending Fundación Universitaria Luis Amigó (FUNLAM) in Medellin during the last six months. METHOD: This was a descriptive cross-sectional study involving a representative sample of 680 students who were surveyed using a questionnaire containing 65 qualitative and quantitative questions in line with sociodemographic variables and risky sexual behavior regarding HIV infection. RESULTS: For each man who had had sexual contact during the past six months there were 0.50 women [PR 0.50: 0.32-0.76 CI] and regarding age there were 0.43 less than or equal to 20 year old students for each college student aged over 20 years old [PR 0.43: 0.29-0.64 CI]. Statistically significant differences were found when comparing psychology students to engineering students [PR 0.32: 0.15-0.69 CI] and when comparing tenth semester students to first, second and fourth semester students [PR 0.11: 0.01-0.88 CI; PR 0.07: 0.00-0.53 CI; PR 0.11: 0.14-0.86 CI, respectively]. CONCLUSION: Sexual practice during the last six months was related to gender and age rather than other demographic variables showing the need to work with young people of both sexes, not just college students, for designing public health prevention and promotion action aimed at minimizing the risk of sexually transmitted HIV infection.

Las prácticas sexuales de riesgo al VIH en población universitaria / Risky sexual behavior regarding HIV in a college population

Objetivo El estudio buscó determinar las prácticas sexuales de riesgo para la infección por VIH que realizaron los estudiantes de la Fundación Universitaria Luis Amigó (Funlam) de la ciudad de Medellín en los últimos seis meses. Método Estudio descriptivo trasversal; con una muestra representativa de 680 estudiantes; se aplicó una encuesta con 65 preguntas cualitativas y cuantitativas, formuladas en coherencia con variables sociodemográficas y prácticas sexuales de riesgo a la infección por VIH. Resultados Por cada un hombre que tuvo prácticas sexuales en los últimos seis meses hubo 0,50 mujeres, [RP 0.50; IC 0,32-0,76]; en cuanto a la edad, por cada universitario mayor de 20 años hay 0,43 menores o iguales a 20 [RP 0,43; IC 0, 29-0,64]; los estudiantes de Psicología presentan diferencias estadística significativas en relación con estudiantes de Ingeniería, [RP 0,32; IC 0,15-0,69]; asimismo, los estudiantes del décimo semestre en comparación con los del primero, segundo y cuarto, [RP 0,11; IC 0,01-0,88], [RP 0,07; IC 0,00-0,53], [RP 0,11; IC 0,14-0,86], respectivamente. Conclusión La realización de prácticas sexuales en los últimos seis meses, depende del sexo o la edad más que por otras variables sociodemográficas, lo cual evidencia la necesidad de hacer un trabajo con poblaciones jóvenes de ambos sexos, no solo universitarios para que desde la salud pública se diseñen acciones que vayan en la dirección de la prevención y la promoción para minimizar los riesgos de infección al VIH por vía sexual.

Objective The study addressed risky sexual behavior regarding HIV infection in students attending Fundación Universitaria Luis Amigó (FUNLAM) in Medellin during the last six months. Method This was a descriptive cross-sectional study involving a representative sample of 680 students who were surveyed using a questionnaire containing 65 qualitative and quantitative questions in line with sociodemographic variables and risky sexual behavior regarding HIV infection. Results For each man who had had sexual contact during the past six months there were 0.50 women [PR 0.50: 0.32-0.76 CI] and regarding age there were 0.43 less than or equal to 20 year old students for each college student aged over 20 years old [PR 0.43: 0.29-0.64 CI]. Statistically significant differences were found when comparing psychology students to engineering students [PR 0.32: 0.15-0.69 CI] and when comparing tenth semester students to first, second and fourth semester students [PR 0.11: 0.01-0.88CI; PR 0.07: 0.00-0.53 CI; PR 0.11: 0.14-0.86 CI, respectively]. Conclusion Sexual practice during the last six months was related to gender and age rather than other demographic variables showing the need to work with young people of both sexes, not just college students, for designing public health prevention and promotion action aimed at minimizing the risk of sexually transmitted HIV infection.

Hacia una construcción del concepto violencias escolares / Towards a concept construction of school violence

El presente artículo surge de la revisión documental del concepto violencias escolares en bases de datos, artículos de revista, bibliotecas y demás medios de información, dentro de la investigación: "Violencias escolares presentes en las ins tituciones educativas católicas. Una aproximación a los discursos y prácticas en el Colegio Parroquial Emaús de la ciudad de Medellín", de la Maestría en Intervenciones Psicosociales de la Fundación Universitaria Luis Amigó. La búsqueda documental arrojó tres categorías: Bullying, violencias de los escolares y conflicto escolar, que alimentaron la construcción en torno a la violencia escolar, evidenciando la necesidad de pluralizar el concepto, más allá de tipificarlo en el bullying, para abarcar sus diversas manifestaciones.

This article comes from the review of documents in databases, journal articles, libraries and other ways, in research "School Violence present in Catholic educational institutions. An approach to the discourses and practices in Emaús Parish School of Medellin", within the Maestría en Intervenciones Psicosociales de la Fundación Universitaria Luis Amigó. During the search we found three theoretical framework: Bullying, School Violence, and Conflict School, which fueled construction around school violence evidencing the need to pluralize the concept beyond typify in Bullying, to cover its various manifestations.

Riesgos psicosociales y actitudes sobre prácticas sexuales bajo el efecto del alcohol o drogas en adolescentes de la ciudad de Medellín / Psychosocial Risk and Attitudes about Sexual Practices with Alcohol or Drugs Effects in Adolescents at Medellín

En este artículo se analizan las actitudes cognitivas y los factores psicosociales relacionados con las prácticas sexuales bajo el efecto de alcohol y drogas en adolescentes de la ciudad de Medellín. El tipo de estudio fue no experimental, de nivel descriptivo y correlacional. La muestra estuvo conformada por 955 estudiantes de grados 9.°, 10.° y 11.° de colegios públicos y privados de la ciudad de Medellín. La edad, el sexo, el tipo de familia, las personas encargadas de la crianza, las normas al interior de la familia, la influencia del grupo de pares y las actitudes cognitivas y afectivas juegan un rol importante en la realización de prácticas sexuales riesgosas bajo el consumo del alcohol y las drogas durante la adolescencia.

In this article we examined some psychosocial factors and cognitive attitudes related to sexual practices under the influence of alcohol and drugs among adolescents in the city of Medellín in 2011. The type of study was non-experimental with a descriptive and correlational level. The sample consisted of 955 students in grades 9, 10 and 11 public and private colleges. Age, sex, type of family, persons responsible for raising, group influence and cognitive and affective attitudes; play an important role in the performance of risky sexual practices on the use of alcohol and drugs during adolescence.

Riesgos y consecuencias de las prácticas sexuales en adolescentes bajo los efectos de alcohol y otras drogas / Risks and consequences of the sexual practices in adolescents under the effects of alcohol and other drug consumption

Introducción: la sexualidad, y el consumo de alcohol y drogas en los adolescentes, figuran en la actualidad como uno de los asuntos con mayor prioridad para la salud pública. La preocupación radica en reducir los riesgos de infecciones de transmisión sexual, el virus de la inmunodeficiencia humana y los embarazos tempranos no deseados. Objetivo: analizar las prácticas sexuales bajo el efecto de alcohol y otras drogas, y los riesgos que esto implica, en los adolescentes de la ciudad de Medellín. Métodos: la muestra se estableció mediante método probabilístico aleatorio y por conglomerados. El universo correspondió al número total de estudiantes matriculados en colegios públicos y privados de la ciudad de Medellín de 8vo., 9no., 10mo. y 11no. grados, en el año 2010 (91 857 estudiantes) con edades comprendidas entre los 14 y 17 años. El tamaño muestral incluido fue de 955 estudiantes usando un intervalo de confianza de 95. Se diseñó un estudio descriptivo, transversal para conocer las prácticas sexuales bajo el efecto de alcohol u otras drogas, y los riesgos que corren los adolescentes. Se establecieron frecuencias, porcentajes y asociaciones estadísticas con el programa SPSS, versión 19.0 Resultados: consumir alcohol u otras drogas y tener prácticas sexuales presenta una asociación estadística significativa (p= 0,000). El 62,4 % de los adolescentes que han consumido una sustancia psicoactiva, han tenido relaciones sexuales, frente a un 29,4 % que, habiendo consumido alcohol y otras drogas, no lo han hecho. El alcohol es la droga más usada (79,8 %). Le siguen la marihuana (31,83 %), poppers (8,97 %), la cocaína (7,75 %) y el éxtasis (5,71 %). Las prácticas sexuales más frecuentes bajo el efecto de sustancias psicoactivas son las exploratorias (manoseo, caricias), para un 71,02 %, seguida de la penetrativa vaginal (63,67 %), el sexo oral (45,30 %) y la masturbación (19,59 %). De los adolescentes que tienen prácticas sexuales (N= 561) bajo el efecto de las drogas, el 12,47 % no han usado métodos de protección, y las consecuencias más significativas han sido las infecciones de trasmisión sexual (2,0 %) y el embarazo no deseado (2,8 %). No se encontró asociación estadísticamente significativa (p= 0,711) entre tener relaciones sexuales bajo el efecto de alcohol o estar sobrios, y el uso de métodos de protección. Conclusiones: se constata lo evidenciado en otras investigaciones, sobre la frecuente asociación entre el consumo de drogas y las prácticas sexuales en adolescentes. Lo que aporta de nuevo este estudio, es dar cuenta del tipo de prácticas bajo el efecto de sustancias psicoactivas, muchas de ellas no exentas de riesgo, y reforzar la necesidad de incluir en los programas de prevención para sexo seguro, acciones para minimizar los daños de tener prácticas sexuales bajo el efecto de sustancias psicoactivas.

Introduction: sexuality, and alcohol and drug consumption by adolescents currently appear as high priority issues for the public health. The concern lies in reducing the risks of sexually transmitted infections, the human immunodeficiency virus and the early unwanted pregnancies. Objectives: to analyze the sexual behaviors under the effect of alcohol and other drug consumption and the inherent risks in adolescents living in Medellin city. Methods: the sample was selected through the random and cluster probabilistic method. The universe of study covered the total number of 8th, 9th, 10th and 11th students from the public and private schools of Medellin in 2010. The age of the 91 857 students ranged 14 to 17 years. The final sample included 955 students, using a 95 % confidence interval. A cross-sectional descriptive study was designed to find out the sexual practices and risks of adolescents under the influence of alcohol and other drug consumption. The SPSS program, version 19.0 served to set frequencies, percentages and statistical associations. Results: taking alcohol or other drugs and having sexual intercourse exhibit a significant statistical association (p=0.000). In the study group, 62.4 % of the adolescents who had taken some psychoactive substances had sexual intercourse whereas 29.4% who had also taken alcohol and other drugs had not. Alcohol was the most used drug (79.8%), followed by marihuana (31.83 %), poppers (8.97 %), cocaine (7.75 %) and ecstasy (5.71 %). The most frequent sexual practices under the above-mentioned conditions were exploratory ones such as body touching and caressing (71.02 %); vaginal penetration (63.67 %), oral sex (45.30 %) and masturbation (19.59 %). Of those adolescents who had sexual practices (n= 561) under the influence of drugs, 12.47 % were unprotected, being sexually transmitted diseases (2 %) and unwanted pregnancy (2.8 %) the main consequences. There was no statistically significant association (p= 0.711) between having sexual intercourse under the effect of alcohol or not and the use of sexual protection methods. Conclusions: the study confirmed the results of other research studies about the frequent association between the drug consumption and the sexual practices of adolescents. The new contributions of this study were to show the types of sexual practices under the effect of psychoactive substances, many of which are not risk-free, and to stress the need of including further actions in the preventive programs for safe sex, in order to minimize the harms that the sexual practice under the effect of these substances consumption may cause.