Colombian People Research Articles

Validation of a cross-NTD toolkit for assessment of NTD-related morbidity and disability. A cross-cultural qualitative validation of study instruments in Colombia.

BackgroundMany neglected tropical diseases (NTDs) are not fatal, but they are disabling, disfiguring and stigmatizing. More accurate data on these aspects would benefit planning, monitoring and evaluation of interventions, as well as provision of appropriate services for the often life-long consequences. In 2015, a cross-NTD toolkit was developed, consisting of a variety of existing questionnaires to measure morbidity, disability and health-related quality of life. The toolkit covers the domains of the International Classification of Functioning, Disability and Health (ICF) framework. These tools have been developed in a source country, however, it was intended for the cross-NTD toolkit to be applicable across NTDs in many countries with different cultures and languages in order to generate universally comparative data. Therefore; the present study aimed to validate several tools of the toolkit among people affected by leprosy or leishmaniasis in the cultural settings of Cartagena and Cúcuta, Colombia.MethodologyThis study aimed to validate the following tools among 55 participants between 18–85 years old, affected by leprosy and leishmaniasis: (I) Clinical Profile, (II) Self-Reporting Questionnaire (SRQ), (III) WHO Quality of Life assessment-abbreviated version (WHOQOL-BREF), and (IV) WHO Quality of Life assessment-Disability (WHOQOL-DIS). The tools were administered during face-to-face interviews and were followed by open questions about the respondents’ thoughts on format of the tool and the understanding, relevance and acceptability of the items. The tools were validated using a qualitative method approach based on the framework for cultural equivalence, measured by the cultural, item, semantic and operational equivalences.ResultsThe Clinical Profile was seen as acceptable and relevant, only the semantic equivalence was not as satisfying and needs a few adaptations. The SRQ was very well understood and shows to reach the equivalences for the population of Colombia without any additional changes. Several items of the WHOQOL-BREF and the WHOQOL-DIS were not well understood and changes are recommended due to semantic difficulties. Operational equivalence of both questionnaires was not as desired in relation to the used response scales. The participants shared that the tools are relevant and important for their particular situation.Conclusions/SignificanceThe SRQ is found to be a valid tool for Colombia and can be included in the cross-NTD toolkit. The Clinical Profile, WHOQOL-BREF & WHOQOL-DIS need changes and retesting among Colombian people affected by an NTD. The toolkit as a whole is seen as useful to show the effects leprosy and leishmaniasis have on the participants. This cultural validation will contribute to a universally applicable cross-NTD toolkit.

Estructura factorial del Cuestionario de Apoyo Social MOS en ancianos colombianos con dolor crónico.

El Cuestionario de Apoyo Social MOS es uno de los instrumentos que mas se utilizan en la investigacion y en la practica gerontologica, pero no hay estudios acerca de su validez para la evaluacion de ancianos colombianos. El objetivo de esta investigacion fue valorar si la estructura de 4 factores descrita en otras poblaciones es valida, estudiar la fiabilidad y determinar diferencias atribuibles a genero y convivencia con una pareja. Se trabajo con una muestra intencional de 463 mayores, de diversas regiones de Colombia. El analisis estadistico de los items evidencio ausencia de normalidad y altas correlaciones inter items e item-escala (superiores a .60), por lo que se selecciono el metodo de Minimos Cuadrados no Ponderados (ULS) para el analisis factorial confirmatorio, con el que se evaluaron tres modelos (de un factor, de tres y de cuatro factores correlacionados) siendo el de 4 factores el que obtuvo mejores indices (NFI=.997; AGFI=.996; RMR=.056; NFI=.996). Los coeficientes alfa de las subescalas estaban entre .86 y .98. Se encontraron diferencias significativas en apoyo social percibido atribuibles al genero y a tener pareja. Los resultados sustentan la validez del cuestionario MOS para la evaluacion del apoyo social percibido por adultos mayores colombianos con dolor cronico.

Iberian-indigenous malice and institutionalization deficit: the origins of a lazy work mentality in Colombia

This article is the result of the historical and documentary review of an investigation which, from a qualitative approach, intended to find the base that built the identity of Colombian people and their behavior towards work and the institutions. It discusses the consequences of the XV Century Spanish conquest model, the deficit of institutionalization and the initial concept of work in the creation of institutions as an essential condition for social cohesion. All of which might still affect the understanding of illegality as a favorable environment for the emergence of multiple informal or marginal trades in some social spheres. These contexts end up consolidating themselves as the basis of an illegal 'industry' permanently reinventing itself, giving rise to the development of certain skills, including Iberian-indigenous malice, necessary for survival in the Colonial period, that later could have had an impact on the emergence of illegal behavior.

Characterization of clinical isolates of Mycobacterium tuberculosis from indigenous peoples of Colombia

Tuberculosis continues to be a public health priority. Indigenous peoples are vulnerable groups with cultural determinants that increase the risk of the disease. To determine molecular epidemiology and phenotypical features and of Mycobacterium tuberculosis isolates from indigenous people in Colombia during the period from 2009 to 2014. We conducted an analytical observational study; we analyzed 234 isolates to determine their patterns of sensitivity to antituberculosis drugs and their molecular structures by spoligotyping. The isolates came from 41 indigenous groups, predominantly the Wayúu (13.10%) and Emberá Chamí (11.35%). We found 102 spoligotypes distributed among seven genetic families (37.2% LAM, 15.8% Haarlem, 8.1% T, 3.4% U, 2.6% S, 2.1% X, and 0.9%, Beijing). The association analysis showed that the non-clustered isolates were related to prior treatment, relapse, orphan spoligotypes, and the Beijing family. The H family presented an association with the Arhuaco and Camëntŝá indigenous groups, the U family was associated with the Wounaan group, and the T family was associated with the Motilón Barí group. This is the first national study on M. tuberculosis characterization in indigenous groups. The study evidenced that diagnosis in indigenous people is late. We described 53% of orphan patterns that could be typical of the Colombian indigenous population. The high percentage of grouping by spoligotyping (62%) could indicate cases of active transmission, a situation that should be corroborated using a second genotyping marker. A new Beijing spoligotype (Beijing-like SIT 406) was identified in Colombia.

A gravity model analysis of forced displacement in Colombia

Between 1985 and 2016 more than 7 million people were victims of forced displacement in Colombia. At the height of the conflict, more than 90% of municipalities in the country saw some form of displacement. In this study we extend the traditional gravity model of migration to analyze the flows of internally displaced people in Colombia between 1986 and 2015, and identify some of the main factors involved in people's choice of destination. We find violence at the origin municipality to be the most important driver of displacement. Similarly, destination municipalities with larger social networks of victims of displacement, larger overall populations, and closer to places of origin attract more displaced people. We propose forced displacement be treated as regional-level phenomenon and planners, city officials, and aid organizations focus their attention on medium-sized regional centers. Because of the importance of social networks in driving people's choice of destination, city officials, planners and aid organizations should closely collaborate with grassroots community organizations to adequately allocate resources and plan for new arrivals.

Young people in Colombia and Brazil in an individualistic society in search of decent work and social security

En la presente investigación se pretende hacer un análisis de la situación real en que viven los jóvenes en América Latina, específicamente en Colombia y Brasil, señalando que son un bono demográfico que debe ser aprovechado en la región. La identificación de los jóvenes tan solo se hará en el siglo XX, definiéndose en el marco legal de Brasil como joven a las personas de 15 a 29 años y en Colombia a las de 14 a 28 años. Igualmente, se hará un acercamiento de los jóvenes y el trabajo, de los jóvenes y la transición educación-trabajo, de la informalidad en los jóvenes, demostrando que esta situación afecta más a las mujeres que a los hombres. Sumado a lo anterior se evidencian los jóvenes que se encuentran excluidos de la sociedad, sin estudio y sin trabajo. Con esto se concluye que en Colombia y en Brasil no se hace una diferenciación del joven en el trabajo, ni en la seguridad social, lo que afecta de manera directa su acceso en un futuro a una pensión.

Abuse in Colombian elderly and its association with socioeconomic conditions and functionality.

Objective: To describe the presence of abuse in elderly people in Colombia and its association with socio-demographic and functional conditions.Methods: Cross-sectional and descriptive research. Data were taken from the SABE Colombia Survey, a population study, with a national representative sample of 23,694 adults aged over 60 years. Presence and type of abuse by partners or family members, members were investigated. Generalized linear models with Poisson link function were used to estimate the causes of the prevalence of abuse by area of residence, region, age, sex, dependence on activities of daily living and living arrangements.Results: 15.1% of the elderly in Colombia reported some type of abuse, and over 50% reported more than one form of abuse. Abuse proportion is greater in people who are aged 60-69, in women, people with lower levels of education, people who belong to lower socioeconomic status, people who live alone, people who live with children, and people in urban areas. The most frequent abuse form is psychological, followed by neglect and physical abuse. Dependence on basic and instrumental daily living activities increases the probabilities of suffering abuse.Conclusions: Home is a risky place for the elderly people, especially for those with functional dependence, those who belong to low socioeconomic strata and women. Results should encourage debate among researchers, professionals and decision makers on public policy about necessary actions and means to change violent family dynamics in homes with elderly people.

Geographies of the Sea: Negotiating Human–Fish Interactions in the Waterscapes of Colombia’s Pacific Coast

The realities of many coastal dwellers have been shaped by their interactions with fish and water along the world’s waterscapes. However, human and cultural geographers have largely overlooked how waterscapes influence coastal people’s behaviors and social interactions. Studies of geographies of the sea have acknowledged the importance of human–nonhuman interactions in the context of fluid ocean spaces and political economies. Critically engaging capitalist, industrialized perspectives of oceans, our article contributes to this literature to study how Afro-descendant small-scale fishers in the Gulf of Tribugá respond to intensifying neoliberal fishing regimes in Colombia’s Pacific coast. We do so by examining how fishers negotiate diverse representations of fish and how these influence their behaviors and practices over time and space. We bring the sea to the center of inquiry to investigate how the sociomaterial character of fish intersects with political, economic, and cultural forces and how they influence perceptions, access, and use of oceans. We argue that the scarcity induced by industrial fisheries overexploitation has changed people’s access to and control over fish and enabled biodiversity conservation discourses to marketize and transform fishing practices. This process has added value to fish through the creation of marine protected areas and the rebranding of fish in terms of traceability and “valued-added” sustainability. In this context, however, we highlight how fishers and their practices have endured through situated institutional practices despite being wrapped up in the complex power dynamics that have marginalized Afro-descendant people in Colombia since colonial times. Key Words: assemblage, Colombia, geographies of the sea, institutions, neoliberalism.

Between panic and hope: Indigenous peoples, gold, violence(s) and FPIC in Colombia, through the lens of time

This article considers the relationship between gold mining, violence(s) and Indigenous peoples through the lens of legal pluralities with a focus on the dimension of time. Drawing on the specific case of the Embera Chamí of the Resguardo Indígena [Indigenous Reserve] of Cañamomo Lomaprieta in Colombia, I ask: What can an analysis through the lens of time unearth around the type of violence(s) that extractives engender for Indigenous peoples and their ancestral lands? I ground my analysis with concepts emerging from the literature around extractives and legal pluralities, such as Stuart Kirsch’s (2014) “politics of time’; Boaventura Santos’ (2002) “instant” and “glacial time”; and the “lethal” and “ancestral time” that emerge from my own work with Indigenous and Afro-Descendant peoples in Colombia. I develop a typology of actors and legalities vying to regulate the Resguardo’s gold, further developing my concept of “raw law” through the dimension of time. And I show what happens when the Resguardo’s authorities appropriate free, prior and informed consent as a tool towards self-government within this context of inter-i-legality. I take up Lemaitre and Sandvik’s (2015) call to theorize differently contexts of violence, reflecting also critically on ethical implications for activism and collaborative research.

Labor insertion of young people in Colombia. Challenges and perspectives

espanolEn este articulo se analiza la insercion laboral de los jovenes en Colombia, para tal fin se analiza la Gran Encuesta Integrada de Hogares realizada por el Departamento Administrativo Nacional de Estadistica – DANE durante el periodo 2008-2015 para las 13 principales areas metropolitanas del pais. Como principales resultados se encuentra los altos niveles de desempleo de los jovenes de hogares de bajos ingresos, con bajos niveles de educacion y las mujeres jovenes; adicionalmente, se encontro una alta proporcion de jovenes sin contrato escrito, lo que dificulta el acceso a un trabajo laboral estable y de calidad. Se concluye que es necesario fortalecer las politicas de acceso al trabajo para los jovenes, dado que persiste el desempleo juvenil y la precariedad laboral. EnglishThis article analyzes the labor insertion of young people in Colombia. To reach this purpose, the Gran Encuesta Integrada de Hogares (Great Integrated Household Survey) applied by the Departamento Administrativo Nacional de Estadistica -DANE- (National Administrative Department of Statistics) during the period 2008-2015 to 13 main metropolitan areas in the country was analyzed. The main results are the high levels of unemployment among young people from low-income households, with low levels of education and young women. Also a high proportion of young people working without a written contract was found, which hinders access to stable and quality work. It is concluded that it is necessary to strengthen policies on access to work for young people given that their unemployment and job insecurity persist.

Epañol

The conflict has left more than 220.000 dead people in Colombia from which 81,5% corresponds to civilians, for this, the proposals of social entrepreneurs for the end of the conflict include education. Utopia is a project that integrates the generation of educational and productive opportunities for young people of rural sectors with limited economic resources, and that who have been affected by violence. This article is the result of the research Social Entrepreneurship in a Colombian University that offers education to students victims of the conflict throughout the country. The Utopia project is a program taken to rural areas with low income students living in contexts of violence. Their graduates are trained to be leaders in their places of origin.

Arañas de importancia clínica-epidemiológica en Colombia

Las arañas son artrópodos venenosos y su accidente se denomina “araneismo” que en nuestro territorio es asociado principalmente con los géneros Loxoceles, Latrodectus y Phoneutria, hay otras arañas con un menor riesgo clínico. Objetivo: Se pretende con este artículo contextualizar al lector en el impacto de estos animales venenosos en la salud de los colombianos desde el punto de vista clínico epidemiológico, con valoración de conceptos y presentando fundamentos teóricos. Metodología: se realizó una revisión de 117 artículos y libros, durante el período comprendido entre febrero 2019-junio de 2020, utilizando las bases de datos Medline, Scopus, Bione, Ebsco, Lilacs, Pubmed, Science Direct, Scielo, Web of Science, además se presentan dos casos, uno en La Mesa, Cundinamarca y otros en Sincelejo, Sucre. Conclusiones: Se concluye que las arañas de importancia clínica-epidemiológica están ampliamente distribuidas en el territorio nacional, las de mayor impacto son Phoneutria, Latrodectus y Loxoceles, siendo esta última la que causa mayores afectaciones en las poblaciones humanas y animales en el país.

Establishing the thermal patterns of healthy people from Medellín, Colombia

Infrared Thermography has been used in the medical field to diagnose illnesses that produce temperature variations. Furthermore, comparisons between the temperatures of contralateral regions or patients and healthy people are used as thermography diagnostic criteria. Under both approaches, the difference in temperature is calculated and, if it falls outside normal ranges, it is considered a sign and symptom of illness. In previous works, the thermal patterns of healthy individuals have been determined in populations from Finland, Portugal, Taiwan, Brazil, and Mexico. However, a comparison of such patterns reveals meaningful discrepancies since the emissivity of the human skin depends on ethnic characteristics and age. Thus, it is necessary to estimate thermal patterns in healthy people from each population and calculate the maximum and minimum temperature differences in their contralateral regions. Specifically, the thermal patterns of healthy Colombian people have not been established so far. Therefore, this work aims to define the thermal patterns of the population of Medellín-Colombia. Such patterns can later be used as reference values to diagnose illnesses in different hospitals in the city. Thirty-seven healthy individuals participated in this study. Data was acquired from the anterior, posterior, right, and left side of the body using a FLIR A655SC thermal camera, and the acquisition protocol was defined in accordance with the method of previous work. The camera recorded twenty-four thermograms from each subject, which were segmented by region-growing and a grid mask algorithm, thus obtaining 43 regions of interest (ROI). The mean temperature and standard deviations of each ROI were also calculated. In most regions, the mean temperature varied between 31.16 °C and 34.58 °C. The lowest mean temperature and highest variability were found in acral regions. Independent samples were assumed in the statistical analysis, and the normality of the temperature of each ROI was verified by the Shapiro–Wilk test. Moreover, Student’s t-test and Mann–Whitney U test were used in the comparison of temperatures of contralateral regions with normal and non normal distributions, respectively. Finally, the temperature difference was found to be insignificant.

Towards a Post-conflict Economy

After four years of negotiations between the Colombian government and the guerrilla of the Revolutionary Armed Forces of Colombia-People’s Army (FARC-EP for its acronym in Spanish), from Havana, Cuba, on August 24, 2016, representatives of Cuba and Norway, guarantor countries, together with the negotiating parties, issued a joint communication in which they announced to the Colombian people and to the entire world the end of a conflict that lasted more than six decades, since they have reached a “final, integral, and definitive agreement on all points of the agenda of the General Agreement to End the Conflict and to Build a Stable and Lasting Peace in Colombia.” This agreement was ratified by the Congress of the Republic and then submitted to a referendum on October 2, 2016, so that the Colombian people decide on the final approval of its implementation (Gobierno Nacional y FARC-EP, 2016).

Restablecer la Armonía: Remedios desde los Pueblos Nasa y Guna para la Sanación de la Madre Tierra

La principal fortaleza metodológica del presente trabajo es que se sustenta en los procesos de los pueblos, Guna en Panamá y Nasa en Colombia. Asegura que la palabra dialogue entre comunidades de la región que están librando una batalla por una Madre Tierra que demanda equilibrio y restauración de la armonía y la paz. Representa el sentir popular e indígena, una reflexión desde la experiencia y la simbología propia. Su estilo, estructura y justificación reconfiguran la colonialidad del pensamiento y el conocimiento. ¿De dónde viene la enfermedad que enferma la Pacha Mama?. Es una pregunta que sin duda, tiene origen en los grupos económicos que controlan el capitalismo, industrias extractivas, megaproyectos mineros, hidroeléctricos y petroleros. Para los pueblos indígenas, las compañías petroleras y de gas, leñadores, mineros y empresarios son los causantes de los daños a su territorio, la contaminación de los ríos, la destrucción de la flora y la fauna.

La Fuerza del Ombligo, Pedagogía de la Vida

El Cultivo y Crianza de Sabidurías y Conocimientos la “Fuerza del Ombligo, Pedagogía de la Vida”, es un estudio que fluye y se entreteje como parte importante del camino recorrido por los pueblos originarios en Colombia revitalizados con la sabiduría que les otorga la Uma Kiwe (Madre Tierra) y el cosmos. Reflexiona en torno al mundo de los conocimientos, asegurando que con la occidentalidad estos quedan limitados a la escuela, mientras, en los pueblos originarios, se potencian en la tierra y en el territorio. Es un estudio que brota desde el relato, “la conversa” y los espacios de encuentros originados en las asambleas y las reuniones familiares con mayoras, mayores, sabedoras y sabedores, recuperando desde esta sabiduría la práctica de la comunicación que ha guiado el camino de la comunidad para defender el territorio, la identidad y la pervivencia del Pueblo Nasa. La riqueza del estudio trasciende las rupturas profundas y el dolor provocado por el conflicto armado colombiano y se centra en los desafíos presentes que tiene el Pueblo Nasa, por conservar sus raíces, prácticas, tradiciones, conocimientos, identidad, permanencia y lengua materna, la Nasa Yuwe. Cuentan los mayores que gracias a la lengua se lograron avances en la recuperación de la tierra. Con esta importancia, el documento intenta cultivar ese saber que también brota desde el vientre de la Uma Kiwe (guiador espiritual).

PMD73 - ECONOMIC IMPACT OF THE TREATMENT OF PRIMARY OPEN-ANGLE GLAUCOMA ON HIP FRACTURE: A COST-EFFECTIVENESS ANALYSIS

World prevalence of glaucoma in people between 40-80 years is projected at 76 million people in 2020. A metanalysis found that risk of a fall in people whose visual impairment was caused by glaucoma, was greater versus population with general disability. This study estimates the cost-effectiveness of trabecular micro-bypass stent versus medications only for intraocular pressure control for patients with open-angle glaucoma. A Markov model, with stages from 0 (ocular hypertension without glaucoma) to 5 and bilateral blindness was developed inclusive of Colombian people older than 40 years in 2018 from a societal perspective, comparing trabecular micro-bypass stent versus timolol+dorzolamide+latanoprost or timolol+dorzolamide+brimatoprost or timolol+brimonidine, in terms of clinical and economic outcomes over a lifetime horizon. Both costs and health outcomes had an annual rate discount of 5%. Health outcomes were evaluated in terms of hip fractures avoided and life years gained (LYG) by deaths avoided, related with hip fractures complications. Trabecular micro-bypass costs include use of latanoprost in 80% of patients. Trabecular micro-bypass stent were estimated to have 10,569 discounted LYG more than timolol+dorzolamide+latanoprost or timolol+dorzolamide+brimatoprost, and 11,413 discounted LYG more than timolol+brimonidine. Trabecular micro-bypass stent avoided 27 hip fractures versus timolol+dorzolamide+latanoprost or timolol+dorzolamide+brimatoprost, and 29 versus timolol+brimonidine. Cumulative costs at 40 years with trabecular micro-bypass stent were € $3.756.198 lower than timolol+dorzolamide+latanoprost; € $10.539.157 lower than timolol+dorzolamide+brimatoprost; and € $6.830.957 lower than timolol+brimonidine. With a willingness-to-pay of USD $6,380 GDP per capita, trabecular micro-bypass stent has a probability of 81% to be chosen. In one-way sensitive analysis, with the lowest efficacy of trabecular micro-bypass and the highest efficacy of medications only, trabecular micro-bypass stent always was dominant. Trabecular micro-bypass stent were estimated to be a highly cost-saving strategy, because have more LYG by deaths avoided related with hip fractures complications and avoid more hip fractures.

Alcoholism in internally displaced people of Colombia: An ecological study

Alcoholism in internally displaced people of Colombia: An ecological study

Fat-to-Muscle Ratio: A New Anthropometric Indicator as a Screening Tool for Metabolic Syndrome in Young Colombian People.

Fat-to-muscle ratio has been proposed as an alternative approach for assessing body fat. The objective of this study was to explore fat-to-muscle ratio thresholds in metabolic syndrome (MetS) diagnosis; it was hypothesised that the fat-to-muscle ratio is a good predictive indicator of MetS in a large population of young Colombian adults. For this purpose, a cross-sectional study was conducted on 1416 subjects (66.6% female), aged from 18.1 to 25.1. As part of the study, measurements of the subjects’ anthropometric indicators, serum lipid indices, blood pressure, and fasting plasma glucose were taken. Body composition was measured through bioelectrical impedance analysis (BIA). A new variable (ratio of fat mass to muscle mass, in kg) was calculated. Following the International Diabetes Federation (IDF) definition, MetS includes three or more metabolic abnormalities. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of the fat-to-muscle ratio to predict MetS. According to the IDF, the best fat-to-muscle ratio cut-off point for detecting MetS in men was 0.225 kg, with an area under the curve (AUC) of 0.83, sensitivity of 80%, and specificity of 70%. For women, the fat-to-muscle ratio cut-off point was 0.495 kg, the AUC was 0.88, and the sensitivity and specificity were 82% and 80%, respectively. In conclusion, our results showed that the fat-to-muscle ratio cut-off points from ROC analyses demonstrate good discriminatory power for detecting MetS in young Colombian adults.

Semantic memory for objects, actions, and events in Colombian people with aphasia

Semantic memory for objects, actions, and events in Colombian people with aphasia