La sexualidad reproductiva en el siglo XXI. El divorcio entre sexualidad y reproducción

El gran avance de la ciencia médica y la aparición de la biotecnología han traído como consecuencia la desvinculación entre sexualidad y reproducción. Desde de la aparición de la pastilla anticonceptiva hasta nuestros días, los avances biotecnológicos han permitido, cada vez más, desvincular el acto sexual de la reproducción humana. Actualmente, procedimientos como la inseminación artificial o la fecundación in vitro (FIV) son cada día más comunes, y en un futuro quizá no tan lejano la clonación de seres humanos traerá profundos cambios en el binomio sexualidad-reproducción. Estos temas y sus posibles implicaciones son el objeto de estudio del presente trabajo.

Eficiencia reproductiva de diferentes genotipos bovinos en la Amazonia Ecuatoriana

Los problemas reproductivos en el centro de la Amazonia Ecuatoriana, están condicionados por un sin número de factores, que directa e indirectamente conspiran para mejorar los parámetros productivos de la zona. Las condiciones ambientales, el manejo, la falta de energía en la dieta, la salud, la infraestructura y los genotipos utilizados influyen para no lograr una eficiente reproducción Lopez et al., 2014). El anestro posparto es el principal factor que afecta negativamente el desempeño reproductivo en la Amazonía. La corta duración del estro y la tendencia a mostrar el estro durante la noche, afectan en gran medida la eficiencia de los programas de inseminación artificial en las áreas tropicales (Baruselli et al., 2004). El objetivo del trabajo fue evaluar la eficiencia de la preñez en diferentes genotipos en vacas primíparas en la Amazonía Ecuatoriana.

Estudio comparativo de la eficiencia reproductiva de bovinos Holstein antes y después de la suplementación con glicerina cruda

Tesis (Médico Veterinario). -- Universidad de La Salle. Facultad de Ciencias Agropecuarias. Programa de Medicina Veterinaria, 2014

Representaciones sociales en lactancia materna de un grupo de 14 mujeres en edad reproductiva de la comunidad educativa de la Universidad de La Salle – sede Chapinero

Tesis (Trabajadora Social).-- Universidad de La Salle. Facultad de Ciencias Económicas y sociales. Programa de Trabajo Social, 2014

Efecto de la extirpación de las espículas del glande del cuy como técnia de esterilización reproductiva y su influencia en agresividad y ganancia de peso en comparación con un método químico alcohol yodado al 2%

La presente investigación evaluó el efecto de la extirpación de las espículas del glande en cobayos como método de esterilización reproductiva y su influencia en agresividad y ganancia de peso en comparación con un método químico (alcohol yodado 2%) y un testigo. Se contemplaron dos etapas de estudio, la primera valoró agresividad y ganancia de peso en 90 cuyes machos de 45 días de edad con peso promedio de 658,3±8,54gr los cuales fueron distribuidos en grupos de 5 animales por jaula; para la segunda etapa se consideró fertilidad y prolificidad en 90 cuyes hembras sexualmente maduras de 3 meses de edad, las cuales fueron empadradas con 18 machos obtenidos al azar de una sub-muestra de la primera etapa, la relación de empadre fue cinco hembras un macho. Los animales en estudio fueron distribuidos en los siguientes tratamientos: T1 animales enteros (n=30), T2 animales extirpados las espículas (n=30) y T3 animales castrados con alcohol yodado 2% (n=30). Los datos obtenidos fueron procesados y analizados en el programa SPSS® versión 22.0 determinándose que la ganancia total de peso fue para T1 836,4±33,89gr, T2 860,5±24,54gr y T3 725,5±30,45 con significancia estadística (P<0,05) para T2 y T1 con relación a T3. En referencia a agresividad medida a través del daño de la canal a nivel de la zona dorso posterior se obtuvieron resultados porcentuales estadísticos no significativos (p>0,05) entre tratamientos. En cuanto a fertilidad se obtuvo: para T1 un valor de 66,7%, T2 86,7% y T3 12% existiendo significancia estadística (p<0,05) entre tratamientos. Para la variable prolificidad se obtuvo valores medios de: T1 2,47±0,34; T2 3,43±0,32 y T3 0,40±0.22, con diferencias significativas (p<0,05) únicamente para el T3 que fue el que menos crías obtuvo. En conclusión la extirpación de las espículas del glande del cuy no esteriliza reproductivamente por el contrario aumenta el porcentaje de fertilidad, no disminuye agresividad, obtiene pesos no distintos al testigo pero alcanza mejores pesos que el método químico.

Factores asociados a embarazo no deseado en mujeres en edad reproductiva en Colombia 2010

Objetivo: Identificar factores sociodemográficos y de fecundidad, asociados a ocurrencia de embarazo no deseado en mujeres colombianas en edad reproductiva en el año 2010. Métodos: Se realizó estudio retrospectivo de corte transversal, basado en los datos de la ENDS Colombia-2010, del total de mujeres en edad fértil (13-49 años) que al momento de la encuesta se encontraban en embarazo. La variable de interés fue embarazo no deseado, se describió la población a estudio y se evaluó la posible asociación con variables sociodemográficas y de fecundidad, a través de análisis bivariado y multivariado. Se realizaron los mismos análisis por grupo de edad (adolescentes vs adultas). Resultados: La prevalencia de embarazo no deseado en las mujeres colombianas en el 2010 fue de 61,4 %. De acuerdo al modelo de regresión logística, no estar en unión a una pareja (OR: 4,01 IC95%: 3,066-5,269), tener hijos (OR: 2,040 IC95%: 1,581 – 2,631), estar en el quintil de menor riqueza (OR: 2,137 IC95%: 1,328-3,440), y ser adolescente (OR: 1,599 IC95%: 1,183-2,162), son factores que aumentan la probabilidad de tener un embarazo no deseado. Se encontraron diferencias en los factores asociados al realizar segmentación por edad. Conclusiones: La prevalencia de embarazo no deseado permanece alta en Colombia respecto a años anteriores y a otros países. Los resultados pueden ser de utilidad para el desarrollo de políticas en salud sexual y reproductiva teniendo en cuenta los factores asociados identificados priorizando a la población adolescente y de menor estatus socioeconómico, para la prevención de embarazo no deseado en Colombia.

Salud sexual y reproductiva: aspectos de análisis para el departamento de Casanare

La sexualidad y la reproducción están íntimamente ligadas a la calidad de vida, tanto en el ámbito de lo individual como de lo social, por tanto la salud sexual y reproductiva representa un componente esencial para la evaluación de desarrollo de un país, y un tema prioritario en la agenda política mundial y nacional como lo evidencian los objetivos del milenio y de desarrollo sostenible; aunque el país ha dado enormes avances en el tema, aun se presentan grandes retos para el logro y goce efectivo de los derechos sexuales y reproductivos en la población. El objetivo del presente estudio es describir y analizar algunos indicadores de salud sexual y reproductiva en el departamento de Casanare, en el periodo 2008- 2015. Como metodología se usó un diseño descriptivo trasversal, los datos fueron tomados de Sivigila departamental, Estadísticas DANE y del Instituto Nacional de Salud. Se usó SPSS versión 18 y Excel para el análisis de los datos. Como resultados se encontraron altas tasas de prevalencia e incidencia para VIH, sífilis gestacional, y fecundidad en adolescentes en el departamento de Casanare que sobrepasan los indicadores nacionales y presentan tendencia creciente

Salud sexual, SALUD REPRODUCTIVA Y ABORTO: ¿QUÉ DERECHOS?

ResumenEl aborto es un tema debatido desde hace décadas. En España, se ha aprobado recientemente la LO 2/2010, de salud sexual y reproductiva y de la interrupción voluntaria del embarazo, que implica un importante cambio en la regulación del aborto: establece un sistema de aborto a petición de la embarazada en un plazo, manteniendo determinadas indicaciones durante más tiempo. El presente artículo analiza el contenido de la salud sexual y reproductiva, los derechos de la mujer y la protección del no nacido en el Derecho Internacional, así como la jurisprudencia constitucional española y la diferencia sustancial del sistema de plazos respecto al de supuestos, la ética médica al respecto y las exigencias del consentimiento informado. Finalmente, se aborda el problema del consentimiento de los menores a la unión sexual y al aborto.AbstractAbortion is an issue that has been discussed for decades. In Spain, the Law on sexual and reproductive health and the voluntary interruption of pregnancy (LO 2/2010) has been recently passed. It implies an important change in abortion legislation: it states an abortion upon request of the pregnant woman during a predetermined period of time, while maintaining certain regulations for a long time. This article analyzes the content of sexual and reproductive health, women’s rights and the protection of the unborn under International Law, as well as the constitutional Spanish jurisprudence; the essential difference of the term-based system in regards to the assumptions system, medical ethics on this matter and the requirements of the informed consent. Lastly, the article deals with the problem of the minors’ consent to sexual union and abortion.

Cross-national epidemiology of DSM-IV major depressive episode

Background: Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low- to middle-income countries. In this paper, we present data on the prevalence, impairment and demographic correlates of depression from 18 high and low-to middle-income countries in the World Mental Health Survey Initiative. Methods: Major depressive episodes (MDE) as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults. Results: The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the ten high-income and 11.1% and 5.9% in the eight low- to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24.0 in low- to middle-income countries. Functional impairment was associated with recency of MDE. The female: male ratio was about 2: 1. In high-income countries, younger age was associated with higher 12-month prevalence; by contrast, in several low-to middle-income countries, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed. Conclusions: MDE is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH.

Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys

Background: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Methodology/Principal Findings: Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. Conclusions/Significance: This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt.

Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys

Background: Suicide is a leading cause of death worldwide. Mental disorders are among the strongest predictors of suicide; however, little is known about which disorders are uniquely predictive of suicidal behavior, the extent to which disorders predict suicide attempts beyond their association with suicidal thoughts, and whether these associations are similar across developed and developing countries. This study was designed to test each of these questions with a focus on nonfatal suicide attempts. Methods and Findings: Data on the lifetime presence and age-of-onset of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) mental disorders and nonfatal suicidal behaviors were collected via structured face-to-face interviews with 108,664 respondents from 21 countries participating in the WHO World Mental Health Surveys. The results show that each lifetime disorder examined significantly predicts the subsequent first onset of suicide attempt (odds ratios [ORs] = 2.9-8.9). After controlling for comorbidity, these associations decreased substantially (ORs = 1.5-5.6) but remained significant in most cases. Overall, mental disorders were equally predictive in developed and developing countries, with a key difference being that the strongest predictors of suicide attempts in developed countries were mood disorders, whereas in developing countries impulse-control, substance use, and post-traumatic stress disorders were most predictive. Disaggregation of the associations between mental disorders and nonfatal suicide attempts showed that these associations are largely due to disorders predicting the onset of suicidal thoughts rather than predicting progression from thoughts to attempts. In the few instances where mental disorders predicted the transition from suicidal thoughts to attempts, the significant disorders are characterized by anxiety and poor impulse-control. The limitations of this study include the use of retrospective self-reports of lifetime occurrence and age-of-onset of mental disorders and suicidal behaviors, as well as the narrow focus on mental disorders as predictors of nonfatal suicidal behaviors, each of which must be addressed in future studies. Conclusions: This study found that a wide range of mental disorders increased the odds of experiencing suicide ideation. However, after controlling for psychiatric comorbidity, only disorders characterized by anxiety and poor impulse-control predict which people with suicide ideation act on such thoughts. These findings provide a more fine-grained understanding of the associations between mental disorders and subsequent suicidal behavior than previously available and indicate that mental disorders predict suicidal behaviors similarly in both developed and developing countries. Future research is needed to delineate the mechanisms through which people come to think about suicide and subsequently progress from ideation to attempts.

Development of Lifetime Comorbidity in the World Health Organization World Mental Health Surveys

Context: Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. Objective: To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization World Mental Health Surveys. Design: Nationally or regionally representative community surveys. Setting: Fourteen countries. Participants: A total of 21 229 survey respondents. Main Outcome Measures: First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the World Health Organization Composite International Diagnostic Interview. Results: Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (ie, internalizing or externalizing) associations were generally stronger than between-domain associations. Most time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity and oppositional defiant disorders (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. Conclusions: The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered herein. These common pathways should be the focus of future research on the development of comorbidity, although several important pairwise associations that cannot be accounted for by latent variables also exist that warrant further focused study.

Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys

Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including socio-demographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Conclusions: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. J Clin Psychiatry 2010;71(12):1617-1628 (C) Copyright 2010 Physicians Postgraduate Press, Inc.

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys

Background Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated. Results Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9)=5.5-8.1, P=0.5-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations: Conclusions These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.