Potencialidades e utilização do espaço recreio: um estudo desenvolvido em escolas do 1.º ciclo do ensino básico

Dissertação apresentada para a obtenção do grau de Mestre em Educação - Área de Especialização em Didática das Ciências

Men's Rugby (1981-82)

Back Row: J.B. Owens, Ross Smith (Head Coach), Adam Frost, Derrick Harwood, Dave DeRose, Bill Arniel, Danny Mazor, Alan Ross, Randy McKeller, Pete McDougall, Ray D'Archi, Kelvin Oda, Mark Pelletier, Eric Thompson, Marty Houston, Ken White (Asst. Coach) Front Row: Peter Love, Chris Peskett, Duff Porteous, Bart Ward, Dave Sohmer, Gary Gautier, Ken Murray, Dave Tamowski, Steve Shaughnessy, Jeff Wood Absent: Alfred Esmaily, Luc Gignac, Fred Kovacs, Andrew Norman

Impact of different irrigation strategies on grapes and wine quality of four grapevine cultivars (Vitis sp.) in cool climate conditions. An investigation into the relationships among ABA, water status, grape cultivar and wine quality

Niagara Peninsula of Ontario is the largest viticultural area in Canada. Although it is considered to be a cool and wet region, in the last decade many water stress events occurred during the growing seasons with negative effects on grape and wine quality. This study was initiated to understand and develop the best strategies for water management in vineyards and those that might contribute to grape maturity advancement. The irrigation trials investigated the impact of time of initiation (fruit set, lag phase and veraison), water replacement level based on theoretical loss through crop evapotranspiration (ETc; 100,50 and 25%) and different irrigation strategies [partial root zone drying (PRD) versus regulated deficit irrigation (RD!)] on grape composition and wine sensory profiles. The irrigation experiments were conducted in a commercial vineyard (Lambert Vineyards Inc.) located in Niagara-on-the-Lake, Ontario, from 2005 through 2009. The two experiments that tested the combination of different water regimes and irrigation time initiation were set up in a randomized block design as follows: Baco noir - three replicates x 10 treatments [(25%, 50% and 100% of ETc) x (initiation at fruit set, lag phase and veraison) + control]; Chardonnay - three replicates x seven treatments [(25%, 50% and 100% of ETc) x (initiation at fruit set and veraison) + control]. The experiments that tested different irrigation strategies were set up on two cultivars as follows: Sauvignon blanc - four replicates x four treatments [control, fully irrigated (100% ETc), PRD (100% ETc) and RDI (25% ETc)]; Cabemet Sauvignon - four replicates x five treatments [control, fully irrigated (100% ETc), PRD (100% ETc), RDI (50% ETc) and RDI (25% ETc)]. The controls in each experiment were nonirrigated. The irrigation treatments were compared for many variables related to soil water status, vine physiology, berry composition, wine sensory profile, and hormone composition [(abscisic acid (ABA) and its catabolites]. Soil moisture profile was mostly affected by irrigation treatments between 20 and 60 em depth depending on the grapevine cultivar and the regime of water applied. Overall soil moisture was consistently higher throughout the season in 100 and 50% ETc compare to the control. Transpiration rates and leaf temperature as well as shoot growth rate were the most sensitive variables to soil water status. Drip irrigation associated with RDI treatments (50% ETc and 25% ETc) had the most beneficial effects on vine physiology, fruit composition and wine varietal typicity, mainly by maintaining a balance between vegetative and reproductive parts of the vine. Neither the control nor the 100 ETc had overall a positive effect on grape composition and wine sensory typicity. The time of irrigation initiation affected the vine physiology and grape quality, the most positive effect was found in treatments initiated at lag phase and veraison. RDI treatments were overall more consistent in their positive effect on grape composition and wine varietal typicity comparing to PRD treatment. The greatest difference between non-irrigated and irrigated vines in most of the variables studied was found in 2007, the driest and hottest season of the experimental period. Soil water status had a greater and more consistent effect on red grapevine cultivars rather than on white winegrape cultivars. To understand the relationships among soil and plant water status, plant physiology and the hormonal profiles associated with it, abscisic acid (ABA) and its catabolites [phaseic acid (PA), dihydrophaseic acid (DPA), 7-hydroxy-ABA (TOH-ABA), 8' -hydroxy-ABA, neophaseic acid and abscisic acid glucose ester (ABA-GE)] were analyzed in leaves and berries from the Baco noir and Chardonnay irrigation trials over two growing seasons. ABA and some of its catabolites accurately described the water status in the vines. Endogenous ABA and some of its catabolites were strongly affected in Baco noir and Chardonnay by both the water regime (i.e. ET level) and timing of irrigation initiation. Chardonnay grapevines produced less ABA in both leaves and berries compared to Baco noir, which indicated that ABA synthesis is also cultivar dependant. ABA-GE was the main catabolite in treatments with high water deficits, while PA and DPA were higher in treatments with high water status, suggesting that the vine produced more ABA-GE under water deficits to maintain rapid control of the stomata. These differences between irrigation treatments with respect to ABA and catabolites were particularly noticeable in the dry 2007 season. Two trials using exogenous ABA investigated the effect of different concentrations of ABA and organs targeted for spraying, on grape maturation and berry composition of Cabemet Sauvignon grapevines, in two cool and wet seasons (2008-2009). The fIrst experiment consisted of three replicates x three treatments [(150 and 300 mg/L, both applications only on clusters) + untreated control] while the second experiment consisted in three replicates x four treatments [(full canopy, only clusters, and only leaves sprayed with 300 ppm ABA) + untreated control]. Exogenous ABA was effective in hastening veraison, and improving the composition of Cabemet Sauvignon. Ability of ABA to control the timing of grape berry maturation was dependant on both solution concentration and the target organ. ABA affected not only fruit composition but also yield components. Berries treated with ABA had lower weight and higher skin dry mass, which constitutes qualitative aspects desired in the wine grapes. Temporal advancement of ripening through hormonal control can lead to earlier fruit maturation, which is a distinct advantage in cooler areas or areas with a high risk of early frost occurrence. Exogenous ABA could provide considerable benefits to wine industry in terms of grape composition, wine style and schedule activities in the winery, particularly in wet and cool years. These trials provide the ftrst comprehensive data in eastern North America on the response of important hybrid and Vitis vinifera winegrape cultivars to irrigation management. Results from this study additionally might be a forward step in understanding the ABA metabolism, and its relationship with water status. Future research should be focused on ftnding the ABA threshold required to trigger the ripening process, and how this process could be controlled in cool climates.

The mexican war and its warriors : comprising a complete history of all the operations of the American armies in Mexic...

UANL

Les procédés scripturaux des salons de clavardage (en français, en anglais et en espagnol) chez les adolescents et les adultes

L’un des aspects les plus percutants des avancées de la technologie des quinze dernières années a trait à la communication médiée par ordinateur : clavardage, messagerie instantanée, courrier électronique, forums de discussion, blogues, sites de réseautage social, etc. En plus d’avoir eu un impact significatif sur la société contemporaine, ces outils de communication ont largement modifié les pratiques d’écriture. Notre objet d’étude est le clavardage en groupe qui offre la possibilité aux scripteurs de communiquer simultanément entre eux. Cet outil de communication présente deux caractéristiques importantes aux plans discursif et communicationnel. Premièrement, on admet de façon générale que le clavardage est une forme de communication hybride : le code utilisé est l’écrit, mais les échanges de messages entrent dans une structure de dialogue qui rappelle l’oral. Deuxièmement, le caractère spontané du clavardage impose la rapidité, tant pour l’encodage que pour le décodage des messages. Dans le cadre d’une étude comparative réalisée sur les pratiques scripturales des clavardeurs francophones (Tatossian et Dagenais 2008), nous avons établi quatre catégories générales pour rendre compte de toutes les variantes scripturales de notre corpus : procédés abréviatifs, substitutions de graphèmes, neutralisations en finale absolue et procédés expressifs. Nous voulons maintenant tester la solidité de notre typologie pour des langues dont le degré de correspondance phonético-graphique diffère. En vertu de l’hypothèse de la profondeur de l’orthographe (orthographic depth hypothesis [ODH]; Katz et Frost 1992) selon laquelle un système orthographique transparent (comme l’italien, l’espagnol ou le serbo-croate) transpose les phonèmes directement dans l’orthographe, nous vérifierons si nos résultats pour le français peuvent être généralisés à des langues dont l’orthographe est dite « transparente » (l’espagnol) comparativement à des langues dont l’orthographe est dite « opaque » (le français et l’anglais). Pour chacune des langues, nous avons voulu répondre à deux question, soit : 1. De quelle manière peut-on classifier les usages scripturaux attestés ? 2. Ces usages graphiques sont-ils les mêmes chez les adolescents et les adultes aux plans qualitatif et quantitatif ? Les phénomènes scripturaux du clavardage impliquent également l’identité générationnelle. L’adolescence est une période caractérisée par la quête d’identité. L’étude de Sebba (2003) sur l’anglais démontre qu’il existe un rapport entre le « détournement de l’orthographe » et la construction identitaire chez les adolescents (par ex. les graffitis, la CMO). De plus, dans ces espaces communicationnels, nous assistons à la formation de communautés d’usagers fondée sur des intérêts communs (Crystal 2006), comme l’est la communauté des adolescents. Pour la collecte des corpus, nous recourrons à des échanges effectués au moyen du protocole Internet Relay Chat (IRC). Aux fins de notre étude, nous délimitons dans chacune des langues deux sous-corpus sociolinguistiquement distincts : le premier constitué à partir de forums de clavardage destinés aux adolescents, le second à partir de forums pour adultes. Pour chacune des langues, nous avons analysé 4 520 énoncés extraits de divers canaux IRC pour adolescents et pour adultes. Nous dressons d’abord un inventaire quantifié des différents phénomènes scripturaux recensés et procédons ensuite à la comparaison des résultats.

Application et efficacité d'une thérapie basée sur les inférences auprès d'une population d'accumulateurs compulsifs: une étude de cas clinique.

Essai doctoral présenté à la Faculté des Arts et des Sciences Humaines en vue de l'obtention du grade de doctorat en psychologie clinique (D.Psy)

Meteorological aspects of an abnormal cooling event over Iran in April 2009

During the period from 12 to 15 April, 2009 nearly the entire Iran, apart from the southern border, experienced an advective cooling event. While winter freezing concerns are typical, the nature of this freezing event was unusual with respect to its date of occurrence and accompanying synoptic meteorological situation. To analyze the freezing event, the relevant meteorological data at multiple levels of the atmosphere were examined from the NCEP/ NCAR reanalysis dataset. The results showed that a polar vortex was responsible for the freezing event over the country extending southward extraordinarily in such a way that its ridge influenced most parts of Iran. This was recognized as an abnormal extension of a polar vortex in the recent years. The sea-level pressure fields indicated that a ridge of large-scale anticyclone centered over Black Sea extended southward and prevailed over most parts of Iran. This resulted in the formation of a severe cold air advection from high latitudes (Polar region) over Iran. During the study period, moisture pumping was observed from the Arabian Sea and Persian Gulf. The winds at 1000 hPa level blew with a magnitude of 10 m s-1 toward south in the region of convergence (between -2 9 10-6 s-1 and -12 9 10-6 s-1). The vertical profilesof temperature and humidity also indicated that the ICE structural icing occurred at multiple levels of the atmosphere, i.e, from 800 hPa through 400 hPa levels. In addition to the carburetor (or induction), icing occurred between 900 and 700 hPa levels in the selected radiosonde stations during the study period. In addition, the HYSPLIT backward trajectory model outputs were in quite good agreement with the observed synoptic features

Modelling of global crop production and resulting N2O emissions

Landwirtschaft spielt eine zentrale Rolle im Erdsystem. Sie trägt durch die Emission von CO2, CH4 und N2O zum Treibhauseffekt bei, kann Bodendegradation und Eutrophierung verursachen, regionale Wasserkreisläufe verändern und wird außerdem stark vom Klimawandel betroffen sein. Da all diese Prozesse durch die zugrunde liegenden Nährstoff- und Wasserflüsse eng miteinander verknüpft sind, sollten sie in einem konsistenten Modellansatz betrachtet werden. Dennoch haben Datenmangel und ungenügendes Prozessverständnis dies bis vor kurzem auf der globalen Skala verhindert. In dieser Arbeit wird die erste Version eines solchen konsistenten globalen Modellansatzes präsentiert, wobei der Schwerpunkt auf der Simulation landwirtschaftlicher Erträge und den resultierenden N2O-Emissionen liegt. Der Grund für diese Schwerpunktsetzung liegt darin, dass die korrekte Abbildung des Pflanzenwachstums eine essentielle Voraussetzung für die Simulation aller anderen Prozesse ist. Des weiteren sind aktuelle und potentielle landwirtschaftliche Erträge wichtige treibende Kräfte für Landnutzungsänderungen und werden stark vom Klimawandel betroffen sein. Den zweiten Schwerpunkt bildet die Abschätzung landwirtschaftlicher N2O-Emissionen, da bislang kein prozessbasiertes N2O-Modell auf der globalen Skala eingesetzt wurde. Als Grundlage für die globale Modellierung wurde das bestehende Agrarökosystemmodell Daycent gewählt. Neben der Schaffung der Simulationsumgebung wurden zunächst die benötigten globalen Datensätze für Bodenparameter, Klima und landwirtschaftliche Bewirtschaftung zusammengestellt. Da für Pflanzzeitpunkte bislang keine globale Datenbasis zur Verfügung steht, und diese sich mit dem Klimawandel ändern werden, wurde eine Routine zur Berechnung von Pflanzzeitpunkten entwickelt. Die Ergebnisse zeigen eine gute Übereinstimmung mit Anbaukalendern der FAO, die für einige Feldfrüchte und Länder verfügbar sind. Danach wurde das Daycent-Modell für die Ertragsberechnung von Weizen, Reis, Mais, Soja, Hirse, Hülsenfrüchten, Kartoffel, Cassava und Baumwolle parametrisiert und kalibriert. Die Simulationsergebnisse zeigen, dass Daycent die wichtigsten Klima-, Boden- und Bewirtschaftungseffekte auf die Ertragsbildung korrekt abbildet. Berechnete Länderdurchschnitte stimmen gut mit Daten der FAO überein (R2 = 0.66 für Weizen, Reis und Mais; R2 = 0.32 für Soja), und räumliche Ertragsmuster entsprechen weitgehend der beobachteten Verteilung von Feldfrüchten und subnationalen Statistiken. Vor der Modellierung landwirtschaftlicher N2O-Emissionen mit dem Daycent-Modell stand eine statistische Analyse von N2O-und NO-Emissionsmessungen aus natürlichen und landwirtschaftlichen Ökosystemen. Die als signifikant identifizierten Parameter für N2O (Düngemenge, Bodenkohlenstoffgehalt, Boden-pH, Textur, Feldfrucht, Düngersorte) und NO (Düngemenge, Bodenstickstoffgehalt, Klima) entsprechen weitgehend den Ergebnissen einer früheren Analyse. Für Emissionen aus Böden unter natürlicher Vegetation, für die es bislang keine solche statistische Untersuchung gab, haben Bodenkohlenstoffgehalt, Boden-pH, Lagerungsdichte, Drainierung und Vegetationstyp einen signifikanten Einfluss auf die N2O-Emissionen, während NO-Emissionen signifikant von Bodenkohlenstoffgehalt und Vegetationstyp abhängen. Basierend auf den daraus entwickelten statistischen Modellen betragen die globalen Emissionen aus Ackerböden 3.3 Tg N/y für N2O, und 1.4 Tg N/y für NO. Solche statistischen Modelle sind nützlich, um Abschätzungen und Unsicherheitsbereiche von N2O- und NO-Emissionen basierend auf einer Vielzahl von Messungen zu berechnen. Die Dynamik des Bodenstickstoffs, insbesondere beeinflusst durch Pflanzenwachstum, Klimawandel und Landnutzungsänderung, kann allerdings nur durch die Anwendung von prozessorientierten Modellen berücksichtigt werden. Zur Modellierung von N2O-Emissionen mit dem Daycent-Modell wurde zunächst dessen Spurengasmodul durch eine detailliertere Berechnung von Nitrifikation und Denitrifikation und die Berücksichtigung von Frost-Auftau-Emissionen weiterentwickelt. Diese überarbeitete Modellversion wurde dann an N2O-Emissionsmessungen unter verschiedenen Klimaten und Feldfrüchten getestet. Sowohl die Dynamik als auch die Gesamtsummen der N2O-Emissionen werden befriedigend abgebildet, wobei die Modelleffizienz für monatliche Mittelwerte zwischen 0.1 und 0.66 für die meisten Standorte liegt. Basierend auf der überarbeiteten Modellversion wurden die N2O-Emissionen für die zuvor parametrisierten Feldfrüchte berechnet. Emissionsraten und feldfruchtspezifische Unterschiede stimmen weitgehend mit Literaturangaben überein. Düngemittelinduzierte Emissionen, die momentan vom IPCC mit 1.25 +/- 1% der eingesetzten Düngemenge abgeschätzt werden, reichen von 0.77% (Reis) bis 2.76% (Mais). Die Summe der berechneten Emissionen aus landwirtschaftlichen Böden beträgt für die Mitte der 1990er Jahre 2.1 Tg N2O-N/y, was mit den Abschätzungen aus anderen Studien übereinstimmt.

Assessing adaptation – Climate change and indigenous livelihood in the Andes of Bolivia

Based on a case study of Charazani – Bolivia, this article outlines the understanding of adaptive strategies to cope with climate change and its impact on environmental and socioeconomic conditions that are affecting rural livelihoods. Mainly qualitative methods were used to collect and analyze data following the framework for vulnerability assessments of a socio-ecological system. Climate data reveals an increase of precipitation and temperature during the last decades. Furthermore the occurrence of extreme weather events, particularly drought, frost, hailstorms and consequently landslides and fire are increasing. Local testimonies highlight these events as the principle reasons for agricultural losses. This climatic variability and simultaneous social changes were identified as the drivers of vulnerability. Yet, several adaptive measures were identified at household, community and external levels in order to cope with such vulnerability; e.g. traditional techniques in agriculture and risk management. Gradually, farmers complement these activities with contemporary practices in agriculture, like intensification of land use, diversification of irrigation system and use of artificial fertilizers. As part of a recent trend community members are forced to search for new off-farm alternatives beyond agriculture for subsistence. Despite there is a correspondingly large array of possible adaptation measures that families are implementing, local testimonies point out, that farmers often do not have the capacity and neither the economical resources to mitigate the risk in agricultural production. Although several actions are already considered to promote further adaptive capacity, the current target is to improve existing livelihood strategies by reducing vulnerability to hazards induced by climate change.

La construcción de sentido del inicio de un cambio estratégico en las organizaciones: el caso de la Universidad del Rosario

A través de un caso de estudio se explora cómo la construcción de sentido de un grupo de directivos, bajo una misma inspiración, generó el inicio de un cambio estratégico en una prestigiosa y reconocida universidad colombiana, la Universidad del Rosario. Una institución que en un momento determinado notó que estaba siendo percibida dentro del sector de la educación superior como pequeña, estática en el avance de algunas disciplinas del conocimiento y conservadora; en otras palabras, que estaba perdiendo el reconocimiento que usualmente la había acompañado. A través del estudio de este caso se utilizó la técnica de análisis de discurso para comprender la construcción de sentido del inicio de un cambio estratégico en las organizaciones. Esta técnica permitió analizar la información cualitativa derivada de las entrevistas que se realizaron en profundidad a la cúpula de directivos de la institución y a algunos destacados representantes del sector de la Educación Superior en Colombia. Los resultados sugieren que se hicieron presentes, efectivamente, algunas condiciones específicas que marcaron el inicio de un cambio estratégico en la institución y un viraje en su identidad e imagen. Hechos que se sustentaron en los miembros de un equipo que procuró interpretar y comprender los cambios existentes en el entorno global y local, y asimilar, igualmente, algunos destacados retos que se planteaban por aquella época, al interior de la propia Universidad

Self-organized sociopolitical interactions as the best way to achieve organized patterns in human social systems: going beyond the top-down control of classical political regimes

La monografía presenta la auto-organización sociopolítica como la mejor manera de lograr patrones organizados en los sistemas sociales humanos, dada su naturaleza compleja y la imposibilidad de las tareas computacionales de los regímenes políticos clásico, debido a que operan con control jerárquico, el cual ha demostrado no ser óptimo en la producción de orden en los sistemas sociales humanos. En la monografía se extrapola la teoría de la auto-organización en los sistemas biológicos a las dinámicas sociopolíticas humanas, buscando maneras óptimas de organizarlas, y se afirma que redes complejas anárquicas son la estructura emergente de la auto-organización sociopolítica.

Nuevas tendencias internacionales de la cooperación internacional y la conservación de la biodiversidad: Afectación local y retos institucionales para su financiamiento

No es un misterio que la cooperación internacional está siendo ampliamente revisada por los donantes, especialmente de Europa y Estados Unidos, debido a las crisis que están sufriendo dichas economías, y que exigen mayor concentración de esfuerzos en resolver los problemas internos y dejar para un segundo plano la Ayuda Oficial para el Desarrollo (AOD). En este contexto, la cooperación para la investigación científica y técnica en materia de biodiversidad se torna en un reto para ser alcanzado a través de los mecanismos tradicionales.Ante esta coyuntura, la incorporación de prácticas de mercadeo en el sector ambiental del país debe ser considerada como una alternativa para que los institutos ambientales de Colombia, logren generar recursos propios y poder así, facilitar el cumplimiento de acuerdos internacionales como las Metas Aichi.

Factores que influyen en la actividad de trasplantes en Colombia año 2013. Desde la perspectiva de pacientes renales y de expertos en trasplante de riñón, hígado y corazón

Antecedentes: Se encuentran datos oficiales sobre trasplante de órganos en Colombia desde 2005 del Instituto Nacional de Salud y desde 2008 para riñón por la Cuenta de Alto Costo. Los datos no ofrecen explicación del número de inscritos en lista de espera para trasplante renal, al comparar con otros países: Colombia 4,68% vs. Argentina 27,58% o Estados Unidos 21,73%. Por otra parte no existen datos acerca de factores que influyen en el seguimiento pos-trasplante y no se tienen de sobrevida del receptor y del injerto. Metodología: Investigación de metodología mixta cuantitativa y cualitativa a partir de la información disponible en los informes oficiales y teniendo como fuente primaria pacientes y expertos en el cuidado de paciente antes y después del trasplante. Resultados: Los factores para acceder o no a lista de espera y seguimiento más mencionados son sistema de salud, aspectos éticos en cuanto remisión y autorización. Emerge como categoría la necesidad de un sistema de vigilancia en trasplantes. En la parte cuantitativa se trasplantan más personas si viven en una ciudad con grupo de trasplante 17,6 vs. 8,05%, si pertenecen al régimen contributivo O.R 3,37 p<0,00001, si no tienen diabetes O.R 3,22 p<0,0001 ni hipertensión arterial O.R 2,42 p<0,0001. No se encontró diferencia en cuanto a género O.R 1,01 p 0,57. Conclusiones: Se proponen ajustes al sistema de salud, de la normatividad, de la educación de la promoción de la donación y trasplante en todos los niveles del público y del personal de salud.

Corticosteroides vs dosis bajas de adrenocorticotropina en el tratamiento de espasmos infantiles. Revisión sistemática de la literatura

Antecedentes: El tratamiento de los espasmos infantiles generalmente se realiza con ACTH a pesar de perfil de efectos secundarios y el alto costo financiero. Se ha propuesto el uso de los corticoides como primera línea de tratamiento para la enfermedad, no obstante no existe certeza sobre la eficacia de este esquema. Objetivos: Evaluar la eficacia del uso de los corticoides comparados con la ACTH como primera línea de tratamiento en el manejo de pacientes con espasmos infantiles. Metodología: Se realizó una revisión sistemática de la literatura. La búsqueda se efectuó en las bases de datos Pubmed, Embase, Ovid, LiLaCs y en el registro de ensayos clínicos de Estados Unidos. Se incluyeron estudios en portugués, ingles y español, no se fijo límite de tiempo para la publicación. Se realizó un análisis de riesgo de sesgo y de calidad de la evidencia utilizando el programa GRADEPRO. Se estimaron OR y sus respectivos intervalos de confianza al 95%. Resultados: Se incluyeron 4 estudios, un ensayo clínico y tres estudios de cohorte retrospectiva. Dos estudios aportaron evidencia de calidad moderada y alta. No se encontraron diferencias en la eficacia a corto plazo entre el uso de los corticoides y la ACTH sobre desenlaces clínicos o electroencefalográficos. No se encontraron estudios de seguridad a largo plazo. La seguridad a corto plazo no mostró diferencias. Conclusiones: Es muy probable que el uso de los corticoides como primera línea de tratamiento puedan reemplazar el uso de la ACTH, se requiere estudios de seguridad a largo plazo. La decisión de su uso rutinario debería estar basada en un análisis de costo efectividad y bajo la mirada del balance riesgo/beneficio.

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.