RESUMO
BACKGROUND AND OBJECTIVES: Since its first implementation in 1998, evidence has been presented of the positive impact of the TimeSlips storytelling method for people with dementia in long-term care (LTC) settings. This article extends this evidence in important new directions: it is the longest TimeSlips study to date and the first to evaluate the feasibility of online delivery of the method (in response to the coronavirus disease 2019 [COVID-19] quarantine) and the impact of this on the personhood, quality of life, and psychological well-being of Spanish-speaking participants in non-LTC settings in the Global South. RESEARCH DESIGN AND METHODS: Trained facilitators provided weekly, 1-hr TimeSlips sessions via Zoom over 32 consecutive weeks to 8 participants with dementia. Semistructured interviews of participants and care partners were conducted within 1 week of the final intervention. Thematic analysis evaluated the resultant qualitative data. RESULTS: This online implementation of the TimeSlips creative expression (CE) method reinforced key facets of participants' personhood (self-expression and self-perception, which led in turn to increased care partner appreciation), had a positive impact on key domains of quality of life (mood, energy levels, and cognitive function), and stimulated a key aspect of psychological well-being (the formation and maintenance of social ties). DISCUSSION AND IMPLICATIONS: The online delivery of the TimeSlips method to participants who remain in their own homes is feasible and effective. Future research should compare the benefits of online versus face-to-face delivery of this CE method.
Assuntos
COVID-19 , Demência , Humanos , Demência/psicologia , Qualidade de Vida , Colômbia , QuarentenaRESUMO
Resumen Introducción El embarazo adolescente ha demostrado un comportamiento descendente en los últimos años en Colombia. Sin embargo, las cifras actuales evidencian que prevalece como una problemática de salud pública. Materiales y Métodos Se desarrolló un diseño descriptivo transversal que permitió caracterizar 48 adolescentes gestantes que estudiaban en el año 2014 y primer semestre de 2015 en 22 instituciones educativas públicas de Bucaramanga. Para la recolección de información se utilizó un instrumento adaptado del instrumento de salud del adolescente propuesto por el Centro de Estudios Económicos de la Universidad de los Andes. Se realizó validez del instrumento mediante evaluación de expertos. Se aplicó además Genograma, Ecomapa y APGAR familiar. Resultados Los casos de embarazo adolescente se presentaron con mayor frecuencia en instituciones educativas ubicadas en la zona norte de la ciudad de Bucaramanga especialmente en la comuna 1. La mayoría de las adolescentes recibieron información sobre sistemas reproductivos y relaciones sexuales a una edad promedio de 12 años por parte de sus madres y docentes. Un 70,4% de las participantes considera que falta información sobre educación sexual en los colegios. Un 23% de las gestantes adolescentes refiere agresión física y 12,5% violación. Se encontró un fuerte apoyo social de la gestante adolescente dado por las familias así como debilidad en las redes de apoyo comunitarias. Discusión La mayoría de las características personales, del contexto, y de las familias coinciden con los reportes de la literatura. Conclusiones El embarazo adolescente es una problemática vigente en las instituciones educativas públicas de Bucaramanga y requiere acciones concretas para su prevención y abordaje integral.
Abstract Introduction Adolescent pregnancy rates have decreased over the last years in Colombia. However, current statistics reveal that it keeps being a health public issue. Materials and Methods A descriptive cross-sectional study was conducted to characterize 48 pregnant adolescents studying in 2014 and the first semester of 2015 in 22 public educational institutions in Bucaramanga. An instrument adapted from the adolescent health instrument, which was proposed by the Center for Economic Studies at the Universidad de los Andes, was used to collect information. The instrument was validated through expert assessment. Genogram, eco-map and family Apgar score were also applied. Results Adolescent pregnancy cases were more frequent in educational institutions located in the northern part of Bucaramanga, especially in district 1. Most of the adolescents received information on reproduction systems and sexual relations at an average age of 12 from their mothers and teachers. 70.4% of the participants consider that there is a lack of information on sex education in schools. 23% of the pregnant adolescents reported physical aggression and 12.5% rape. There was strong social support to pregnant adolescents given by their families, as opposed to weaknesses found in the community support networks. Discussion Most personal, contextual and family characteristics coincide with literature reports. Conclusions Adolescent pregnancy is a current issue in public educational institutions in Bucaramanga that requires concrete actions for its prevention and comprehensive approach.
Resumo Introdução A gravidez adolescente já demonstrou um comportamento descendentes nos últimos anos na Colômbia. No entanto, as cifras atuais evidenciam sua prevalência como um problema de saúde pública. Materiais e Métodos Foi desenvolvido um estudo descritivo transversal que permitiu caracterizar 48 adolescentes gestantes que estudavam no ano 2014 e primeiro semestre de 2015 em 22 instituições educacionais públicas de Bucaramanga. Para a compilação da informação, foi utilizado um instrumento adaptado do instrumento de saúde do adolescente proposto pelo Centro de Estudos Econômicos da Universidade de los Andes. O instrumento foi validado mediante a avaliação de peritos. Além disso, foi aplicado um Genograma, um Ecomapa e um APGAR familiar. Resultados Os casos de gravidez adolescente se verificaram com maior frequência em instituições educacionais situadas na zona norte da cidade de Bucaramanga especialmente na comuna 1. A maioria das adolescentes receberam informação sobre sistemas reprodutivos e relações sexuais a uma idade média de 12 anos por parte de suas mães e docentes. Um 70,4% das participantes considera que falta informação sobre educação sexual nos colégios. Um 23% das gestantes adolescentes relata agressão física e 12,5% estupro. Verificou-se um forte apoio social da gestante adolescente dado pelas famílias bem como a fraqueza nas redes de apoio comunitárias. Discussão A maioria das características pessoais, do contexto, e das famílias coincidem com as informações da literatura. Conclusões A gravidez adolescente é uma problemática vigorante nas instituições educacionais públicas de Bucaramanga e precisa de ações concretas para sua prevenção e abordagem integral.
Assuntos
Humanos , Feminino , Educação Sexual , Adolescente , GravidezRESUMO
Introducción: el embarazo adolescente es una problemática que tiene consecuencias en la vida de las adolescentes y sus familias. Conocer las concepciones y representaciones que tienen las adolescentes gestantes es una herramienta fundamental para fortalecer la toma de decisiones y las redes de apoyo social. Objetivo: Identificar las concepciones sobre el embarazo, las características sociales, económicas y de redes de apoyo en un grupo de adolescentes gestantes de Bucaramanga. Materiales y Métodos: Se realizó un estudio cualitativo (estudio de caso) mediante las técnicas de grupo focal, observación participante y elaboración de diario de campo. Se incluyeron 15 participantes de las 100 adolescentes beneficiadas por el Programa Plan Padrino de la Secretaría de Salud y Ambiente de Bucaramanga durante el año 2014. Resultados: La mayoría de las participantes refirieron que, aunque el embarazo fue no deseado lo han aceptado y asumido con grandes cambios en sus vidas, especialmente la relación con sus amigos y con su familia. Identificaron como red de apoyo fundamental la familia. Discusión: Las concepciones sobre embarazo en las adolescentes coinciden con los estudios reportados en Colombia en el sentido que lo asumieron con responsabilidad, pero les representó un doble reto en especial para continuar con sus estudios. Conclusiones: Fortalecer la red de apoyo de las adolescentes en especial la relacionada con procesos educativos y de familia.
Introduction: pregnancy in adolescents is a problem that brings consequences to the lives of adolescent girls and their families. Knowing the conceptions and representations the pregnant adolescents have is a fundamental tool to enhance decision-making and social support networks. Objective: The work sought to identify conceptions about pregnancy, along with social, economic, and support network characteristics in a group of pregnant adolescents from Bucaramanga. Materials and Methods: A qualitative study (case study) was conducted through focal group techniques, participant observation, and elaboration of a field diary. The study included 15 participants of the 100 adolescent girls benefiting from the Plan Padrino program by the Health and Environment Secretary in Bucaramanga during 2014. Results: Most of the participants stated that, although the pregnancy was not desired, they have accepted and assumed it with big changes in their lives, especially the relationship with their friends and family. They identified the family as the fundamental support network. Discussion: The conceptions on pregnancy in adolescents coincide with studies reported in Colombia in the sense that they assumed it with responsibility, but posed a double challenge specifically related to continuing their studies. Conclusions: It is necessary to strengthen the support network of the adolescent girls, especially that related to educational processes and family.
Introdução: a gravidez na adolescência é um problema que tem consequências na vida dos adolescentes e suas famílias. Conhecer as concepções e representações que têm as adolescentes grávidas é uma ferramenta fundamental para fortalecer a tomada de decisões e as redes de apoio social. Objetivo: Identificar as concepções sobre a gravidez, características sociais, econômicas e redes de apoio por um grupo de adolescentes grávidas em Bucaramanga. Materiais e Métodos: Foi realizado um estudo qualitativo (estudo de caso) por meio da técnica de grupo focal, observação participante e elaboração de diário de campo. Foram incluídos 15 participantes das 100 adolescentes beneficiadas pelo Programa Plano Padrinho da Secretaria de Saúde e Ambiente de Bucaramanga durante o ano 2014. Resultados: A maioria dos participantes relataram que, embora a gravidez não fosse desejada, aceitaram e assumiram com grandes mudanças em suas vidas, especialmente a relação com seus amigos e com sua família. Identificaram como rede de apoio fundamental a família. Discussão: As concepções sobre gravidez nas adolescentes coincidem com os estudos relatados na Colômbia no sentido de que é assumido com responsabilidade, mas representou um duplo desafio especialmente para continuar seus estudos. Conclusões: Fortalecer a rede de apoio das adolescentes, especialmente a relacionada aos processos educativos e de família.
Assuntos
Humanos , Adolescente , Gravidez , Rede SocialRESUMO
Introducción: El conocimiento actual sugiere que la enfermedad cardiovascular se origina y progresa desde la infancia y la adolescencia. La disfunción endotelial es un evento temprano y crucial en la aterosclerosis. Pacientes y Método: Estudio prospectivo que comparó la vasodilatación mediada por flujo (VMF) en niños con sobrepeso y niños de peso normal. Para medir la VMF se utilizó transductor adecuado de ultrasonido y el método estándar. Resultados: Ochenta y dos niños fueron incluidos; 49 eran casos (sobrepeso) y 33 controles. Los valores de VMF oscilaron entre -6 y 56% (promedio 11,1%) en niños con sobrepeso y de 0 a 29,6% (promedio 16,6%) en niños control (p < 0,05). Se presentó vasoconstricción paradójica en el 34,7% de los niños con sobrepeso y en ninguno de los controles (p < 0,05). Se encontró una asociación significativa entre vasoconstricción paradójica con obesidad central e hipertensión. Conclusión: Los resultados de este estudio muestran que la VMF es menor en niños con sobrepeso en comparación con los niños eutróficos, por lo que es más probable que exista disfunción endotelial en ellos.
Introduction: Present knowledge suggests that cardiovascular disease originates and progresses from childhood and adolescence. Endothelial dysfunction is an early and crucial event in atherosclerosis. Patients and Method: Prospective study that compares Flow Mediated Vasodilation (FMV) in children with overweight (OWC) and normal weight children. An ultrasound transducer a standard method were used to measure FMD. Results: The study included 82 children, of whom 49 were cases (OWC) and 33 controls. FMV values ranged from -6 to 56% (x = 11.1%) in OW, and from 0 to 29.6% (x = 16.6%) in control children (P<.005). Paradoxical vasoconstriction was found in 34.7% in OWC as compared to nil in controls (P<.005). A significant association was found between vasoconstriction and central obesity and hypertension. Conclusion: The results of this study show that FMV is lower in obese compared to normal children; thus they are more likely to have endothelial dysfunction.
Assuntos
Humanos , Masculino , Feminino , Criança , Vasoconstrição/fisiologia , Vasodilatação/fisiologia , Endotélio Vascular/patologia , Sobrepeso/complicações , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Estudos ProspectivosRESUMO
INTRODUCTION: Present knowledge suggests that cardiovascular disease originates and progresses from childhood and adolescence. Endothelial dysfunction is an early and crucial event in atherosclerosis. PATIENTS AND METHOD: Prospective study that compares Flow Mediated Vasodilation (FMV) in children with overweight (OWC) and normal weight children. An ultrasound transducer a standard method were used to measure FMD. RESULTS: The study included 82 children, of whom 49 were cases (OWC) and 33 controls. FMV values ranged from -6 to 56% (x=11.1%) in OW, and from 0 to 29.6% (x=16.6%) in control children (P<.005). Paradoxical vasoconstriction was found in 34.7% in OWC as compared to nil in controls (P<.005). A significant association was found between vasoconstriction and central obesity and hypertension. CONCLUSION: The results of this study show that FMV is lower in obese compared to normal children; thus they are more likely to have endothelial dysfunction.
Assuntos
Endotélio Vascular/patologia , Sobrepeso/complicações , Vasoconstrição/fisiologia , Vasodilatação/fisiologia , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Estudos ProspectivosRESUMO
La muda es un proceso de renovación de la capa externa de la epidermis (estrato corneo) de los anfibios, la cual suministra protección contra daños, patógenos y pérdida de agua. Este trabajo evalúa la frecuencia de muda entre juveniles y adultos de Rhinella marina (Linnaeus, 1758) y la tasa de ocurrencia entre el día y la noche. Para esto, se realizaron dos observaciones diarias (7 am y 7 pm), entre Octubre de 2011 y Marzo de 2012, a tres grupos de individuos clasificados según su tamaño longitud rostro-cloaca, como adultos (promedio=80 mm), juveniles medianos (promedio=19 mm) y juveniles pequeños (promedio=13 mm). Estos animales fueron colocados en terrarios en el laboratorio y marcados en el dorso a través de un punto hecho con un corrector de tinta. La muda se determinó por la pérdida total de la marca y una coloración brillante en el dorso. Se encontró una diferencia significativa (Kruskal-Wallis, H=19.84, p<0.0001) en el periodo de muda entre los tres grupos de estudio: adultos=7.5 días, juveniles medianos=5.4 días, juveniles pequeños=5.3 días. También, en la frecuencia de animales que mudaron en el día y la noche (Ji-cuadrado, χ2=7.891, p=0.019), particularmente en los dos grupos de juveniles, quienes lo hicieron en la noche, ya que en los adultos no hubo una diferencia clara. Posiblemente, la mayor frecuencia de la muda en los juveniles puede relacionarse con su condición ontogénica, de un menor tamaño corporal, alta tasa metabólica y mayor tasa de desarrollo.
Molting is a process of constant renewal of the outer layer of epidermis (stratum corneum) in amphibians, which provides a barrier against injury, pathogens and evaporative water loss. This paper evaluates the molting frequency between juveniles and adults of Rhinella marina (Linnaeus, 1758) and between the night and day time. Two daily observations, at 7 am and 7 pm, were made between October 2011 and March 2012 to three groups of individuals, classified by their size, snout vent length, as adults (mean=80 mm), medium juveniles (mean=19 mm) and small juveniles (mean=13 mm). The animals were placed in terrariums in the laboratory and marked on their back with a spot of correction fluid. The molting was determined by the total loss of the mark and a bright color on the dorsal skin. We found a significant difference (Kruskal-Wallis, H=19.84, p<0.0001) in the molting frequency among the three groups: adults=7.5 days, medium juveniles=5.4 days, and small juveniles=5.3 days. Also, between the number of molting frogs during the night and day hours (Chi-square, χ 2=7.891, p=0.019), particularly in the two groups of juveniles, who moulted mostly at night, as adults did not show any clear difference. It is possible that the highest molting frequency in juveniles may be related to their ontogenetic status, with a smaller size and higher metabolic and developmental rate.
Assuntos
Animais , Anuros/genética , Biologia do Desenvolvimento , Muda/fisiologia , Muda/genéticaRESUMO
La muda es un proceso de renovación de la capa externa de la epidermis (estrato corneo) de los anfibios, la cual suministra protección contra daños, patógenos y pérdida de agua. Este trabajo evalúa la frecuencia de muda entre juveniles y adultos de Rhinella marina (Linnaeus, 1758) y la tasa de ocurrencia entre el día y la noche. Para esto, se realizaron dos observaciones diarias (7 am y 7 pm), entre Octubre de 2011 y Marzo de 2012, a tres grupos de individuos clasificados según su tamaño longitud rostro-cloaca, como adultos (promedio=80 mm), juveniles medianos (promedio=19 mm) y juveniles pequeños (promedio=13 mm). Estos animales fueron colocados en terrarios en el laboratorio y marcados en el dorso a través de un punto hecho con un corrector de tinta. La muda se determinó por la pérdida total de la marca y una coloración brillante en el dorso. Se encontró una diferencia significativa (Kruskal-Wallis, H=19.84, p<0.0001) en el periodo de muda entre los tres grupos de estudio: adultos=7.5 días, juveniles medianos=5.4 días, juveniles pequeños=5.3 días. También, en la frecuencia de animales que mudaron en el día y la noche (Ji-cuadrado, χ2=7.891, p=0.019), particularmente en los dos grupos de juveniles, quienes lo hicieron en la noche, ya que en los adultos no hubo una diferencia clara. Posiblemente, la mayor frecuencia de la muda en los juveniles puede relacionarse con su condición ontogénica, de un menor tamaño corporal, alta tasa metabólica y mayor tasa de desarrollo.(AU)
Molting is a process of constant renewal of the outer layer of epidermis (stratum corneum) in amphibians, which provides a barrier against injury, pathogens and evaporative water loss. This paper evaluates the molting frequency between juveniles and adults of Rhinella marina (Linnaeus, 1758) and between the night and day time. Two daily observations, at 7 am and 7 pm, were made between October 2011 and March 2012 to three groups of individuals, classified by their size, snout vent length, as adults (mean=80 mm), medium juveniles (mean=19 mm) and small juveniles (mean=13 mm). The animals were placed in terrariums in the laboratory and marked on their back with a spot of correction fluid. The molting was determined by the total loss of the mark and a bright color on the dorsal skin. We found a significant difference (Kruskal-Wallis, H=19.84, p<0.0001) in the molting frequency among the three groups: adults=7.5 days, medium juveniles=5.4 days, and small juveniles=5.3 days. Also, between the number of molting frogs during the night and day hours (Chi-square, χ 2=7.891, p=0.019), particularly in the two groups of juveniles, who moulted mostly at night, as adults did not show any clear difference. It is possible that the highest molting frequency in juveniles may be related to their ontogenetic status, with a smaller size and higher metabolic and developmental rate.(AU)
Assuntos
Animais , Anuros/genética , Muda/genética , Muda/fisiologia , Biologia do DesenvolvimentoRESUMO
La ceftriaxona es ampliamente usada en pediatría debido a su espectro de acción, larga vida media y buena penetración en los sitios donde se asientan las infecciones más frecuentes. Es bien tolerada, aunque, con frecuencia, en niños que la reciben, se presenta barro biliar y pseudocolelitiasis. Esto se ve favorecido porque cerca del 40% del fármaco es eliminado por la bilis sin modificaciones, donde se comporta como un anión con alta afinidad por las sales de calcio. Resumen La mayoría de los casos cursan asintomáticos o mínimamente sintomáticos, y de resolución espontánea solo al suspender el uso del fármaco. Se presenta el caso de una niña de 4 años que recibe ceftriaxona durante 14 días por sinusitis, desarrollando al quinto día cálculos en la vesícula biliar que crecen hasta 11 mm y tardan 55 días en desaparecer; el día 34, presenta colecistitis, colangitis y coledocolitiasis que requieren manejo hospitalario.
Ceftriaxone is widely used in children because it has a great spectrum, long half-life and good penetration. Is generally well tolerated, although in children who receive the drug, it often presented pseudocolelitiasis and biliary sludge. This is favored because about 40% of the drug is eliminated unchanged in bile where it behaves as an anion with high affinity for calcium salts. Most cases present as asymptomatic or minimally symptomatic and spontaneous resolution, only when the drug is no longer taken. A case of a 4 year old girl who received ceftriaxone for 14 days for sinusitis and on day 5 develops gall bladder stones that grow to 11 mm and last 55 days to go away, the day 34 presents cholecystitis, cholangitis and choledocholithiasis requiring medical management to resolution.
Assuntos
Humanos , Feminino , Pré-Escolar , Ceftriaxona , Colangite , Coledocolitíase , Infecções/microbiologia , Sinusite , Bile , Cálculos , Cálculos da Bexiga Urinária , Cálcio , Espectro de Ação , Vesícula Biliar , ÂnionsRESUMO
Las anormalidades congénitas pulmonares constituyen un grupo heterogéneo de alteraciones del desarrollo pulmonar, y muchas de ellas son asintomáticas; sin embargo, es importante conocerlas, pues deben entrar en el diagnóstico diferencial de aquellos pacientes con síndrome de dificultad respiratoria. Algunas de estas lesiones pueden coexistir, al punto de que el secuestro pulmonar puede presentarse con malformación adenomatoide quística tipo II en más del 50 de los casos. Aunque el diagnóstico definitivo para este tipo de lesiones es histológico, las imágenes desempeñan un papel importante para un acercamiento inicial. La historia natural de estas malformaciones pulmonares depende del tamaño de la masa pulmonar y el problema fisiológico que esta cause. La tomografía computarizada de multidetectores ha ampliado el conocimiento de la anatomía pulmonar y mejora la visualización del árbol traqueobronquial en la población pediátrica.
Assuntos
Humanos , Anormalidades Congênitas , Diagnóstico por Imagem , Pneumopatias , Anormalidades do Sistema RespiratórioRESUMO
Endophenotypes are neurobiological markers cosegregating and associated with illness. These biomarkers represent a promising strategy to dissect ADHD biological causes. This study was aimed at contrasting the genetics of neuropsychological tasks for intelligence, attention, memory, visual-motor skills, and executive function in children from multigenerational and extended pedigrees that cluster ADHD in a genetic isolate. In a sample of 288 children and adolescents, 194 (67.4%) ADHD affected and 94 (32.6%) unaffected, a battery of neuropsychological tests was utilized to assess the association between genetic transmission and the ADHD phenotype. We found significant differences between affected and unaffected children in the WISC block design, PIQ and FSIQ, continuous vigilance, and visual-motor skills, and these variables exhibited a significant heritability. Given the association between these neuropsychological variables and ADHD, and also the high genetic component underlying their transmission in the studied pedigrees, we suggest that these variables be considered as potential cognitive endophenotypes suitable as quantitative trait loci (QTLs) in future studies of linkage and association.