This book provides a full, historical, economic, and political context through which to understand the actions of the people and government of Mexico, and it gives insights into how those actions ...impinge -- and might continue to impinge -- on the United States.
The aim of this study was to assess the extent to which adolescents with and without visual and hearing‐related problems meet physical activity (PA) and recreational screen time (ST) recommendations ...in a representative Colombian sample. A total of 35,404 adolescents aged 13–17 years were included from the Encuesta Nacional de Salud Escolar (ENSE) (Colombia). Sociodemographic‐related information, anthropometric variables, PA, ST, and both visual‐ and hearing‐related problems were collected by self‐administered questionnaires. The prevalence of adolescents meeting with PA, ST, and both recommendations was 14.8%, 53.4%, and 7.8%, respectively. Both sexes with visual‐ (males: OR=0.70, 95%CI 0.59–0.83; females: OR=0.73, 95%CI 0.61–0.88) and hearing‐related problems (males, OR=0.75, 95%CI 0.61–0.93; females, OR=0.76, 95%CI 0.61–0.94) are less likely to meet combined recommendations. Sensory problems such as vision‐ and hearing‐related problems could be considered key barriers to engagement in PA and facilitators of recreational ST in Colombian adolescents.
The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for ...implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice.
This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al.
The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice.
The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.
This study analyzes the relationship between gender and self-perceived health status in Spanish retirees and housewives from a sample of 1,106 community-dwelling older adults. A multivariate linear ...regression model was used in which self-perceived health status was measured by the EQ-5D visual analogue scale and gender according to work status (retired men and women and housewives). Retired males reported a significantly better health status than housewives. Self-perceived health status was closely associated with physical, mental, and functional health and leisure activities. Finally, being a woman with complete dedication to domestic work is associated with a worse state of self-perceived health.
Introducción: Los espacios educativos son escenarios configuradores de la vida académica y de experiencias para el desarrollo personal y profesional de estudiantes. Objetivo: Interpretar las ...percepciones de los estudiantes de una universidad pública sobre los espacios educativos. Metodología: Investigación cualitativa, descriptiva interpretativa, técnicas grupos focales y entrevistas en profundidad con estudiantes líderes. Información analizada desde la hermenéutica. Resultados y discusión: Las percepciones sobre espacios físicos, instalaciones y el mobiliario, fueron interpretadas como agente inhibidor de la calidad de vida; se evidencia percepción de seguridad-inseguridad en la ciudad, el uso de bicicleta fue valorado para favorecer la socialización, la salud y el aprendizaje. La dispersión de sedes de la universidad en la ciudad se considera barrera para interacciones cotidianas. Conclusiones: La universidad es experiencia de vida, permite construir y fortalecer trayectorias universitarias, que se relacionan con vivencias en los espacios de la ciudad y aportan el proceso educativo de manera diferencial.
Background: Studied since the 1940s, refeeding syndrome still has no universal definition, thus making comparison of studies difficult. Negative outcomes (eg, metabolic abnormalities) may occur with ...the use of specialized nutrition, such as parenteral nutrition (PN). Less than half of medical institutions have a nutrition support team (NST) managing PN. Interdisciplinary team management of PN may reduce negative outcomes of PN. The objective of this study was to show the value of the NST by measuring differences in PN variables, especially electrolyte abnormalities (EAs), before and after NST initiation at a large medical center and to identify factors associated with EAs among adult subjects receiving PN. Materials and Methods: During this retrospective study, computerized medical charts (N = 735) from 2007–2010 were reviewed for electrolyte changes (particularly potassium, magnesium, and phosphorus) the first 3 days following PN initiation in hospitalized adults. Changes in EAs with other variables were compared before and after NST implementation. Equivalent samples sizes were collected to better evaluate the impact of the team. Results: Following the implementation of the NST, fewer EAs were seen in PN patients (53%; χ2 = 10.906, P = .004); significantly less potassium, phosphorus, and magnesium intravenous piggyback supplementation (88.8% vs 94%; χ2 = 5.05, P = .026) was used; and mortality within 30 days of PN cessation was significantly less (12.7% vs 10.6%, P = .012). Conclusion: Our study complements existing research, finding that an NST was associated with a decreased occurrence of EAs and mortality in the hospitalized adult receiving PN.
Abstract Objective
. To determine the diagnostic accuracy of Thwaites
Index (TI) in a Colombian population to distinguish meningeal tuberculosis (MTB) from bacterial meningitis (BM) and from ...non-tuberculous meningitis. Exploratory analyses were conducted to assess the TI
'
s validity for patients with human immunodeficiency virus (HIV) and children above six-years-old. Methods The study included 527 patients, the TI was calculated and results compared with those of a reference standard established by expert neurologists.
Sensitivity, specificity, area under the curve of receiver-operator characteristics (AUC-ROC) and likelihood ratios were calculated. Results The AUC-ROC to distinguish MTB from non-tuberculous meningitis was 0.72 (95%
CI: 0.67
–
0.77) for HIV negative adults.
AUC-ROC was 0.62 (95%
CI: 0.50
–
0.74) for HIV positive adults and 0.83 (95%
CI: 0.68
–
0.97) for children. For distinguishing MTB from BM the AUC-ROC was 0.78 (95%
CI: 0.73
–
0.83); furthermore, the AUC-ROC was 0.57 (95%
CI: 0.31
–
0.83) for HIV positive adults and 0.86 (95%
CI: 0.73
–
0.99) for children. Conclusion The TI was sensitive but not specific when used to distinguish MTB from BM in HIV negative adults. In HIV positive adults the index had low diagnostic accuracy. Moreover, the TI showed discrimination capability for children over 6 years; however, research with larger samples is required in these.
La presente investigación buscó identificar y analizar la evidencia científica con relación a los comportamientos de riesgo en los estudiantes universitarios, a través de un estudio descriptivo ...documental de la literatura científica mediante la búsqueda en las bases de datos Scielo, PubMed, Redalyc y LILACS; se seleccionaron artículos publicados desde 2010 al 2016, cuyos participantes fueran estudiantes universitarios. Los descriptores fueron: comportamientos de riesgo, factor de riesgo, estudiantes, jóvenes y sus equivalentes en inglés y portugués. Las estrategias de búsqueda se estructuraron mediante la combinación de diferentes descriptores con los operadores booleanos: AND y OR. La muestra final fue de 21 artículos. La evidencia científica permite identificar comportamientos de riesgo en estudiantes universitarios como sedentarismo, estrés, conductas de riesgo frente a la salud sexual y reproductiva, consumo de drogas, entre otros, sobre los cuales es necesario orientar las acciones educativas en el contexto de los currículos universitarios con enfoque humanístico
Abstract
Objective
This work aimed to evaluate the factors associated with
Streptococcus pneumoniae
nasopharyngeal colonization and antimicrobial susceptibility among pediatric outpatients in ...southwestern Colombia, 2019.
Methods
A cross-sectional study was performed using survey-based interviews and the collection of nasopharyngeal-swab specimens for microbiological characterization and antimicrobial susceptibility testing. Logistic regression analyses were performed for factors associated with nasopharyngeal carriage.
Results
A total of 452 children under the age of 5 years were examined in which 41.8% carried
S. pneumoniae
. Higher pneumococcal carriage frequencies were observed among participants aged <2 years and in individuals belonging to indigenous communities, which were lacking established pneumococcal-conjugated vaccine-10 immunization schemes. Additionally, children attending childcare institutions were also highly colonized by pneumococci.
S. pneumoniae
showed 57.7% nonsusceptibility to benzyl-penicillin (meningitis-cut); 45.5% intermediate-sensitivity to benzyl-penicillin (oral-cut) and 21.7% to cefotaxime; and resistance to erythromycin (40.7%), tetracycline (36.0%), trimethoprim/sulfamethoxazole (24.9%), clindamycin (24.3%), and ceftriaxone (27.0%).
Conclusion
The 41.8% of participants carrying
S. pneumoniae
show a scenario with the presence of multidrug and extensively drug-resistant strains, which constitutes important reservoirs of bacterial transmission by children aged <5 years in Colombia, leading to an onset of pneumococcal diseases. Hence, there is an urgent need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.
Genetic white matter disorders (GWMD) are of heterogeneous origin, with >100 causal genes identified to date. Classic targeted approaches achieve a molecular diagnosis in only half of all patients. ...We aimed to determine the clinical utility of singleton whole-exome sequencing and whole-genome sequencing (sWES-WGS) interpreted with a phenotype- and interactome-driven prioritization algorithm to diagnose GWMD while identifying novel phenotypes and candidate genes.
A case series of patients of all ages with undiagnosed GWMD despite extensive standard-of-care paraclinical studies were recruited between April 2017 and December 2019 in a collaborative study at the Bellvitge Biomedical Research Institute (IDIBELL) and neurology units of tertiary Spanish hospitals. We ran sWES and WGS and applied our interactome-prioritization algorithm based on the network expansion of a seed group of GWMD-related genes derived from the Human Phenotype Ontology terms of each patient.
We evaluated 126 patients (101 children and 25 adults) with ages ranging from 1 month to 74 years. We obtained a first molecular diagnosis by singleton WES in 59% of cases, which increased to 68% after annual reanalysis, and reached 72% after WGS was performed in 16 of the remaining negative cases. We identified variants in 57 different genes among 91 diagnosed cases, with the most frequent being
,
,
, and
, and a dual diagnosis underlying complex phenotypes in 6 families, underscoring the importance of genomic analysis to solve these cases. We discovered 9 candidate genes causing novel diseases and propose additional putative novel candidate genes for yet-to-be discovered GWMD.
Our strategy enables a high diagnostic yield and is a good alternative to trio WES/WGS for GWMD. It shortens the time to diagnosis compared to the classical targeted approach, thus optimizing appropriate management. Furthermore, the interactome-driven prioritization pipeline enables the discovery of novel disease-causing genes and phenotypes, and predicts novel putative candidate genes, shedding light on etiopathogenic mechanisms that are pivotal for myelin generation and maintenance.
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