Teleconsultation in sexual and reproductive health for young adults through mobile devices: Experience in Colombia

Background: Sexual risk behaviors associated with poor information on sexuality have contributed to major public health problems in the area of sexual and reproductive health in teenagers and young adults in Colombia. Objective: To measure the perception of changes in sexual and reproductive risk behavior after the use of a teleconsultation service via mobile devices in a sample of young adults. Methods: A before and after observational study was designed, where a mobile application to inquire about sexual and reproductive health was developed. The perception of changes in sexual and reproductive health risk behaviors in a sample of young adults after the use of the application was measured using the validated survey “Family Health International (FHI) – Behavioral Surveillance Survey (BSS) – Survey for Adults between 15 to 40 Years”. Non-probabilistic convenience recruitment was undertaken through the study´s web page. Participants answered the survey online before and after the use of the mobile application for a six month period (intervention). For the inferential analysis, data was divided into three groups (dichotomous data, discrete quantitative data, and ordinal data), to compare the results of the questions between the first and the second survey. For all tests, a confidence interval of 95% was established. For dichotomous data, the Chi-squared test was used. For quantitative data, we used the Student’s t-test, and for ordinal data, the Mann-Whitney-Wilcoxon test. Results: A total of 257 subjects were registered in the study and met the selection criteria. The pre-intervention survey was answered by 232 subjects, and 127 completely answered the post-intervention survey, of which 54.3% did not use the application, leaving an effective population of 58 subjects for analysis. 53% (n=31) were female, and 47% (n=27) were male. The mean age was 21 years, ranging between 18 and 40 years. The differences between the answers on the first and the second survey were not statistically significant. The main risk behaviors identified in the population were homosexual relations, non-use of condoms, sexual relations with non-regular and commercial partners, the use of psychoactive substances, and ignorance about the symptoms of sexually transmitted diseases and HIV transmission. Conclusions: Although there were no differences between the pre- and post-intervention results, the study revealed different risk behaviors among the participating subjects. These findings highlight the importance of promoting educational strategies on this matter and the importance of providing patients with easily accessible tools with reliable health information.

La vía aérea, un reto en el servicio de urgencias indicaciones, manejo y complicaciones

INTRODUCCIÓN: El control rápido y seguro de la vía aérea es una de las habilidades más importantes que se debe tener para el manejo de pacientes críticamente enfermos y traumatizados en los departamentos de emergencias de todo el mundo, en nuestro medio no contamos con estadísticas que cuantifiquen el éxito y complicaciones en este aspecto. METODOLOGIA: Se realizo un estudio observacional, descriptivo, prospectivo, que recolecto los datos de las intubaciones realizadas en la sala de emergencias del Hospital Universitario Mayor “Mederi” por parte de especialistas en medicina de emergencias, medicina interna, médicos generales o personal en entrenamiento, durante el periodo comprendido entre noviembre de 2010 y junio de 2011. RESULTADOS: Se recolecto una muestra de 92 pacientes en el estudio, la causa mas frecuente de intubación orotraqueal fue falla respiratoria 77,2%, el éxito en el primer intento fue de 51,5%, se uso secuencia de intubación rápida como método de intubación en el 56,5% de los pacientes y se presento alguna complicación en el 61% de los pacientes. DISCUSIÓN: El éxito en la intubación orotraqueal es menor y las complicaciones superiores a los de países desarrollados, esto puede estar en relación con la falta del desarrollo de la medicina de emergencias y programas de entrenamiento formal en el manejo de la vía aérea.

Análisis de los elementos de Soft Power presentes en la política exterior alemana de cooperación para el desarrollo (2002-2009)R ALEMANA DE COOPERACIÓN PARA EL DESARROLLO (2002-2009)

A lo largo de la historia el Sistema Internacional se ha configurado a partir de los diferentes polos de poder y de diversas formas de interacción entre actores. Una de estas formas es la cooperación internacional, la cual abre el espacio a nuevos asuntos dentro de la agenda internacional y permite profundizar la colaboración en determinados temas de interés de los actores. Esta forma de relacionamiento puede ser entendida como una herramienta de Soft Power definiéndose éste como un elemento que permite a los Estados influenciar dentro del sistema internacional por medio de acciones no bélicas y que facilita el acercamiento de los países desarrollados con los países en vías de desarrollo para moldear el sistema internacional. Siguiendo esta idea, el Estado Alemán ha implementado el uso del Soft Power dentro de su política exterior buscando generar beneficios tanto a Alemania como para los Estados receptores de cooperación. Alemania ha redefinido sus prioridades: ajustar y reorganizar sus estrategias de cooperación para optimizar recursos, teniendo en cuenta la historia alemana y los cambios estructurales que las dos guerras mundiales generaron en la perspectiva de su política exterior. La fuerte y firme estructura política, económica y social ha permitido que este sea el único país de la Unión Europea que no ha sufrido directamente la crisis económica y por lo tanto ha logrado seguir aportando parte de su PIB a la cooperación internacional. Esto ha generado un diálogo político entre diferentes países, el cual permite el acercamiento con los gobiernos de turno en cada Estado para la creación de políticas encaminadas al desarrollo y al mejoramiento de la calidad de vida de los ciudadanos.

Gasto de bolsillo en rehabilitación

En el presente estudio aunque se encontraron dificultades en cuanto a información sobre el gasto de bolsillo en rehabilitación en los diferentes continentes, se establecieron diferentes perspectivas que nos llevaron a tener un acercamiento de manera cuantitativa y cualitativa del gasto de bolsillo que requieren las personas en discapacidad específicamente en la ciudad de Bogotá, para poder acceder a los servicios de Rehabilitación, estos gastos no son reconocidos por el plan de beneficios en salud lo que conlleva a la generación de una problemática que esta directamente relacionada con el desmejoramiento de las condiciones económicas y sociales de esta población estado y aun más cuando los costos son más altos y el acceso es mas restringido a nivel de rehabilitación.

Tendencias de las flores Colombianas en el mercado de la Unión Europea, especialmente en el Reino Unido y España.

El objetivo de esta monografía es analizar el desarrollo del comercio exterior de las flores colombianas en la Unión Europea, en especial con Reino Unido y España en los próximos años, reconociendo los marcos bajo los cuales ha sido dirigido este intercambio.

Influencia del bajo peso al nacer en el cumplimiento del esquema de vacunación en Colombia

INTRODUCCION. En Colombia y a nivel mundial la vacunación es una estrategia que ha reducido la mortalidad infantil, sin embargo existen bajas coberturas en algunas zonas del país, dentro de las causas de la no vacunación se encuentra el bajo peso al nacer, tema de gran importancia y poco estudiado, encontrándose como una causa controlable y que permitiría a la población acceder a la protección frente a enfermedades inmunoprevenibles. MATERIALES Y METODOS. Se realizó un estudio de tipo observacional de corte trasversal, la muestra fue tomada de la ENDS realizada por Profamilia en el año 2010, se tomó el número total de los encuestados que cumplían con los criterios de inclusión, en total fueron 9694 registros a los que se les realizo; análisis descriptivo, bivariado y multivariado. RESULTADOS. Los niños con bajo peso al nacer tienen menor probabilidad de estar vacunados con el esquema completo con respecto a los niños con peso normal, OR 0762 (IC 95% 0,650; 0,895), se observó que las vacunas en forma individual tienen un comportamiento similar al esquema completo, específicamente en la aplicación en el tiempo indicado para su aplicación, exceptuando triple viral donde no se encontró asociación. CONCLUSION. El bajo peso es un factor determinante en la vacunación a tiempo de los menores y del cumplimiento posterior del esquema, se encontraron variables asociadas al no cumplimiento como el lugar del parto, el índice de pobreza y pertenecer a la etnia afrodescendiente.

La alianza de estados insulares pequeños y la securitización del cambio climático en la convención marco de Naciones Unidas sobre cambio climático (1992-2012)

La presente monografía busca explicar el proceso de securitización realizado por la AOSIS del cambio climático en las COP de la CMNUCC. Esta investigación defiende que la AOSIS sí ha hecho dicho proceso a través de estrategias como el liderazgo moral y los nexos con actores no-estatales; pero dicho proceso no ha sido exitoso, dado el predominio del discurso del desarrollo sostenible en las negociaciones, el debilitamiento de la AOSIS como actor securitizador y el poco apoyo formal de las potencias emergentes y el bloque UMBRELLA. Para sustentar lo anterior, se realizará una revisión de informes científicos que demuestran que el cambio climático es una amenaza a la seguridad, y un estudio desde de la teoría de securitización de Thierry Balzacq, de los discursos dados por los estados AOSIS, de las COP y de las posiciones de algunos bloques de negociación sobre el cambio climático.

Análisis de la política exterior de Irán y su influencia sobre la política de Seguridad y defensa de Israel. Período 2005-2011

En la presente monografía se analizarán los factores de la política exterior iraní que han incidido en la política de seguridad y defensa de Israel. Se examina y explica bajo la teoría del Realismo Ofensivo, cuyo máximo representante es John Mearsheimer, el cual expone acerca las dinámicas de los países desarrollados con respecto al ámbito de seguridad, en donde los Estados están interesados principalmente en aumentar su seguridad con el objetivo de sobrevivir, lo cual resulta incompatible con otros Estados. Por último, se identifica de forma documentada cuales son los aspectos afectados en la seguridad de Israel a partir de la política exterior del gobierno de Mahmoud Ahmadinejad y cómo el Estado judío ha utilizado otras estrategias que anteriormente no había recurrido.

Fate and effects of copper in fluvial ecosystems: the role of periphyton

L'activitat humana és una de les majors causes d'elevades concentracions de nutrients i substàncies tòxiques en els ecosistemes fluvials. Entre la gran varietat de factors que alteren aquests ecosistemes, l'eutrofització i la contaminació per metalls pesants són dos dels principals problemes ambientals en països desenvolupats. Els biofilms fluvials (també anomenats comunitats perifítiques) representen una eina valuosa per avaluar els efectes dels contaminants (ex. nutrients i metalls) en els ecosistemes aquàtics. Aquest treball pretén investigar el destí i els efectes del Cu en els ecosistemes fluvials centrant-se en les comunitats perifítiques. Diferents metodologies han estat desenvolupades i/o adaptades per investigar específicament la dinàmica del Cu, la seva toxicitat i bioacumulació en comunitats perifítiques naturals, i la interacció entre l'eutrofització i la toxicitat del Cu en aquests ecosistemes.

Women on March in Goa : the gender transition in Higher Education after the Statehood

This paper attempts to address the interesting phenomenon of dominance of women in higher educational sector of Goa-a remarkable postcolonial event which occurred after Goa attained statehood in 1987. The Indian state of Goa has been experiencing a rapid socio-economic and cultural transformation. At present it enjoys many of the highest human development indicators in India, matching some of the developed countries. Its’ projected population at present is 1.45 million (Indian decennial census 2001 reported 1.348 million). When the Portuguese rule ended, the literacy was just 31 % whereas it stood at 82 % in 2001. Goa is a highly urbanized state in India. In 1960 there were just five towns and 15 % urban population. In 2001 the figures were, 44 towns and 50 % urban population. On economic front Goa has made tremendous progress mainly on account of the growth of mining, tourism and the service sector. Tourist arrivals in Goa have exceeded the state’s population from 2001. The Gross state domestic product (GSDP) at current prices in 2003-04 was Indian Rupees (Rs.) 96570 million, up from Rs. 3930 million when Goa became a full-fledged state. The banks are flush with funds indicating a booming economy. Goa has lowest birth and death rates and a life expectancy of 68 years for the males and 72 for females. The sex ratio however has shown a declining trend since 1960, from 1066 to 960 in 2001 (Table 1).The sex ratio for 0-6 years age group was 933. On this background we intend to examine the changing pattern of female education in Goa.

Post-neoliberal electricity market ‘re-reforms’ in Argentina: Diverging from market prescriptions?

This paper focuses upon the policy and institutional change that has taken place within the Argentine electricity market since the country’s economic and social crisis of 2001/2. As one of the first less developed countries (LDCs) to liberalise and privatise its electricity industry, Argentina has since moved away from the orthodox market model after consumer prices were frozen by the Government in early 2002 when the national currency was devalued by 70%. Although its reforms were widely praised during the 1990s, the electricity market has undergone a number of interventions, ostensibly to keep consumer prices low and to avert the much-discussed energy ‘crisis’ caused by a dearth of new investment combined with rising demand levels. This paper explores how the economic crisis and its consequences have both enabled and legitimised these policy and institutional amendments, while drawing upon the specifics of the post-neoliberal market ‘re-reforms’ to consider the extent to which the Government appears to be moving away from market-based prescriptions. In addition, this paper contributes to sector-specific understandings of how, despite these changes, neoliberal ideas and assumptions continue to dominate Argentine public policy well beyond the postcrisis era.

Long-chain n−3 PUFA: plant v. marine sources

Increasing recognition of the importance of the long-chain n-3 PUFA, EPA and DHA, to cardiovascular health, and in the case of DHA to normal neurological development in the fetus and the newborn, has focused greater attention on the dietary supply of these fatty acids. The reason for low intakes of EPA and DHA in most developed countries (0 center dot 1-0 center dot 5hairspg/d) is the low consumption of oily fish, the richest dietary source of these fatty acids. An important question is whether dietary intake of the precursor n-3 fatty acid, alpha-linolenic acid (alpha LNA), can provide sufficient amounts of tissue EPA and DHA by conversion through the n-3 PUFA elongation-desaturation pathway. alpha LNA is present in marked amounts in plant sources, including green leafy vegetables and commonly-consumed oils such as rape-seed and soyabean oils, so that increased intake of this fatty acid would be easier to achieve than via increased fish consumption. However, alpha LNA-feeding studies and stable-isotope studies using alpha LNA, which have addressed the question of bioconversion of alpha LNA to EPA and DHA, have concluded that in adult men conversion to EPA is limited (approximately 8%) and conversion to DHA is extremely low (< 0 center dot 1%). In women fractional conversion to DHA appears to be greater (9%), which may partly be a result of a lower rate of utilisation of alpha LNA for beta-oxidation in women. However, up-regulation of the conversion of EPA to DHA has also been suggested, as a result of the actions of oestrogen on Delta 6-desaturase, and may be of particular importance in maintaining adequate provision of DHA in pregnancy. The effect of oestrogen on DHA concentration in pregnant and lactating women awaits confirmation.

Investment in preventing and preparing for biological emergencies and disasters: social and economic costs of disasters versus costs of surveillance and response preparedness

Biological emergencies such as the appearance of an exotic transboundary or emerging disease can become disasters. The question that faces Veterinary Services in developing countries is how to balance resources dedicated to active insurance measures, such as border control, surveillance, working with the governments of developing countries, and investing in improving veterinary knowledge and tools, with passive measures, such as contingency funds and vaccine banks. There is strong evidence that the animal health situation in developed countries has improved and is relatively stable. In addition, through trade with other countries, developing countries are becoming part of the international animal health system, the status of which is improving, though with occasional setbacks. However, despite these improvements, the risk of a possible biological disaster still remains, and has increased in recent times because of the threat of bioterrorism. This paper suggests that a model that combines decision tree analysis with epidemiology is required to identify critical points in food chains that should be strengthened to reduce the risk of emergencies and prevent emergencies from becoming disasters.

Food consumption impacts of adherence to dietary norms in the United States: a quantitative assessment

Promotion of adherence to healthy-eating norms has become an important element of nutrition policy in the United States and other developed countries. We assess the potential consumption impacts of adherence to a set of recommended dietary norms in the United States using a mathematical programming approach. We find that adherence to recommended dietary norms would involve significant changes in diets, with large reductions in the consumption of fats and oils along with large increases in the consumption of fruits, vegetables, and cereals. Compliance with norms recommended by the World Health Organization for energy derived from sugar would involve sharp reductions in sugar intakes. We also analyze how dietary adjustments required vary across demographic groups. Most socio-demographic characteristics appear to have relatively little influence on the pattern of adjustment required to comply with norms, Income levels have little effect on required dietary adjustments. Education is the only characteristic to have a significant influence on the magnitude of adjustments required. The least educated rather than the poorest have to bear the highest burden of adjustment. Out- analysis suggests that fiscal measures like nutrient-based taxes may not be as regressive as commonly believed. Dissemination of healthy-eating norms to the less educated will be a key challenge for nutrition policy.

Food consumption impacts of adherence to dietary norms in the United States: a quantitative assessment

Promotion of adherence to healthy-eating norms has become an important element of nutrition policy in the United States and other developed countries. We assess the potential consumption impacts of adherence to a set of recommended dietary norms in the United States using a mathematical programming approach. We find that adherence to recommended dietary norms would involve significant changes in diets, with large reductions in the consumption of fats and oils along with large increases in the consumption of fruits, vegetables, and cereals. Compliance with norms recommended by the World Health Organization for energy derived from sugar would involve sharp reductions in sugar intakes. We also analyze how dietary adjustments required vary across demographic groups. Most socio-demographic characteristics appear to have relatively little influence on the pattern of adjustment required to comply with norms, Income levels have little effect on required dietary adjustments. Education is the only characteristic to have a significant influence on the magnitude of adjustments required. The least educated rather than the poorest have to bear the highest burden of adjustment. Out- analysis suggests that fiscal measures like nutrient-based taxes may not be as regressive as commonly believed. Dissemination of healthy-eating norms to the less educated will be a key challenge for nutrition policy.