Resumen Introducción: La prevención, identificación, análisis y reducción de los eventos adversos (EA), son actividades direccionadas a incrementar la seguridad de la atención en el entorno clínico. El estudio de los casos cerrados es una estrategia que permite identificar problemas relacionados con la seguridad del paciente. En este estudio se analizan eventos adversos conducentes a procesos medicolegales cerrados contra anestesiólogos afiliados a un fondo de aseguramiento en Colombia entre 2013-2019. Objetivo: Analizar los eventos adversos en procesos medicolegales cerrados de anestesiólogos afiliados a un fondo de aseguramiento entre 2013-2019. Métodos: Estudio observacional de corte transversal. Se analizó una muestra a conveniencia en la que se incluyeron todos los casos cerrados en los que anestesiólogos afiliados a un fondo de aseguramiento en Colombia fueron objeto de reclamaciones en el período de observación. Se analizaron variables relacionadas con la presentación del EA. Resultados: Se analizaron 71 reclamaciones, de las cuales el 33,5 % fueron por EA relacionado con anestesia. Los eventos adversos se encontraron con mayor frecuencia en pacientes ASA I-II (78,9 %), y en procedimientos quirúrgicos (95,8 %). El mayor número de eventos adversos se presentó en cirugía plástica (29,6 %); el evento de mayor proporción fue el fallecimiento del paciente (43,7 %). En un importante número de casos se demostró fallos en el registro de la historia clínica e incumplimiento de normas. Conclusiones: En relación con un estudio publicado previamente en la misma población, se encuentra un incremento en los procesos éticos, disciplinarios y administrativos, motivados por eventos sin una relación directa con el acto anestésico. La mayoría de eventos adversos relacionados con anestesia se presentan en procedimientos quirúrgicos, en salas de cirugía, en pacientes y procedimientos catalogados como de bajo riesgo, y son en su mayoría prevenibles.

Abstract Introduction: Prevention, identification, analysis and reduction of adverse events (AEs) are all activities designed to increase safety of care in the clinical setting. Closed claims reviews are a strategy that allows to identify patient safety issues. This study analyzes adverse events resulting in malpractice lawsuits against anesthesiologists affiliated to an insurance fund in Colombia between 2013-2019. Objective: To analyze adverse events in closed medicolegal lawsuits against anesthesiologists affiliated to an insurance fund between 2013-2019. Methods: Cross-sectional observational study. Convenience sampling was used, including all closed claims in which anesthesiologists affiliated to an insurance fund in Colombia were sued during the observation period. Variables associated with the occurrence of AEs were analyzed. Results: Overall, 71 claims were analyzed, of which 33.5% were due to anesthesia-related AEs. Adverse events were found more frequently among ASA I-II patients (78.9%), and in surgical procedures (95.8%). The highest number of adverse events occurred in plastic surgery (29.6%); the event with the highest proportion was patient death (43.7%). Flaws in clinical records and failure to comply with the standards were found in a substantial number of cases. Conclusions: When compared with a previously published study in the same population, an increase in ethical, disciplinary and administrative claims was found, driven by events not directly related to anesthesia. Most of the anesthesia-related events occurred in the operating room during surgical procedures in patients and procedures categorized as low risk, and most of them were preventable.

Abstract The agricultural sector was one of the sectors that was most compromised during the confinements in the COVID-19 pandemic, guaranteeing the value chain and the necessary inputs. But even so, the problems of the sector are still evident: poverty, inequity, lack of rural and non-rural employment, low profit rates, lack of distribution chains and market development, among others. An alternative that is presented to achieve successful productive chains is that of inclusive businesses, for its better application and understanding, the application of a biological metaphor of coevolution and mutualism is presented in this document, noting that inclusive businesses should not occur. only on occasions of vulnerable producers, but to recognize in them their skills, knowledge, and capacities that they can share and put in favour of the integration model to achieve joint developments with the other organizations in the chain. The proposal focuses on strengthening inclusive models from the recognition of diversity and difference, and the development of management alternatives for the entire chain in general.

Resumen El sector agropecuario fue uno de los más comprometidos durante los confinamientos en la pandemia de COVID-19, garantizando la cadena de valor y los insumos necesarios. Pero, aun así, los problemas del sector siguen siendo evidentes, pobreza, inequidad, falta de empleo rural y no rural, bajas tasas de ganancia, falta de cadenas de distribución y desarrollo de mercados, entre otros. Una alternativa para lograr encadenamientos productivos exitosos es la de los negocios inclusivos. Para una mejor aplicación y entendimiento, este documento presenta la aplicación de una metáfora biológica de la coevolución y el mutualismo, señalando que los negocios inclusivos no solo deben darse en productores vulnerables, sino que deben reconocer sus habilidades, conocimientos y capacidades que pueden compartir y utilizar a favor del modelo de integración, para lograr desarrollos conjuntos con otras organizaciones de la cadena. La propuesta se centra en fortalecer los modelos inclusivos desde el reconocimiento de la diversidad y la diferencia, y el desarrollo de alternativas de gestión para toda la cadena en general.

Resumen Introducción: El riesgo de suicidio entre anestesiólogos parece ser mayor que el que se presenta en otras especialidades, posiblemente debido al elevado estrés asociado con la especialidad, al fácil acceso a medicamentos potentes y al conocimiento íntimo de cómo usarlos. En Colombia poco se sabe sobre el impacto del suicidio de un colega en un departamento de anestesia y los recursos disponibles para afrontar esta situación. Objetivo: Con esta encuesta se buscó identificar de manera indirecta la frecuencia de suicidio entre anestesiólogos colombianos y las experiencias relacionadas con el suicidio de un colega. Métodos: Estudio observacional de corte transversal de tipo encuesta aplicada a todos los anestesiólogos afiliados a la Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.) a escala nacional. Resultados: Se obtuvo respuesta de 403 anestesiólogos. Ochenta (19,8 %) participantes indicaron tener conocimiento de la muerte por suicidio de al menos un colega. La mayoría corresponden a anestesiólogos o intensivistas de sexo masculino, y el grupo etario con mayor número de reportes es el de 25 a 29 años para el sexo masculino. El principal mecanismo causal identificado fue la intoxicación por opioides (58,5 %). Conclusiones: En una caracterización indirecta del suicidio en anestesiólogos colombianos se encontraron 99 informes de suicidio reportados por 80 anestesiólogos. El suicidio es prevenible, en los sitios de trabajo deben existir los mecanismos de apoyo para la identificación del estrés laboral, la farmacodependencia, la depresión y el suicidio.

Abstract Introduction The risk of suicide among anesthesiologists seems to be higher than in other areas of specialization, probably because of the significant stress associated with this specialty, easy access to strong medications and the profound knowledge about the use of these drugs. There is a poor knowledge about the impact of suicide on anesthesiologists in Colombia and the resources available to deal with this situation are limited. Objective This survey is intended to indirectly identify the frequency of suicide among the Colombian anesthesiologists and the experiences associated with the suicide of a colleague. Methods Observational, cross-sectional study based on a survey administered to all the anesthesiologists members of the Colombian Society of Anesthesiology and Resuscitation (S.C.A.R.E.), at a national scale. Results 403 anesthesiologists completed the survey. Eighty (19.8 %) of the respondents said they were aware of the death of at least one colleague that committed suicide. Most of them are male anesthesiologists or intensivists, and the age group with the highest rate of reports is between 25 - 29 years old in males. The primary causal mechanism was opioid overdose (58.5 %). Conclusions In an indirect characterization of suicide among Colombian anesthesiologists, 99 suicide reports were identified corresponding to 80 anesthesiologists. Suicide is preventable and the worksite should provide the support mechanisms required to identify occupational stress, drug dependence, depression and suicide.

Resumen El artículo analiza los métodos alternativos de resolución de Conflictos-MASC de cara a los retos y problematizaciones que afronta la administración de justicia alternativa con la supresión de la función conciliatoria a las comisarías de familia en casos de violencia familiar. La metodología se basa en revisión documental y bibliográfica respecto a las normas constitucionales y legales que regulan la conciliación y el impacto socio-jurídico que la normativa imprime en términos de acceso y descongestión judicial por la mengua de instituciones y funcionarios facultados para conciliar en asuntos de violencia intrafamiliar. Los resultados indican que la Constitución Política de 1991, consagró una estructura excepcional y transitoria para la resolución de las controversias a través de la conciliación y ello facilita la protección de derechos de carácter fundamental, pero también de contenido económico. Se concluye que la eliminación de la función conciliatoria a las comisarías de familia en casos de violencia familiar disminuye el efecto de los mecanismos alternativos, siendo necesario crear políticas públicas que respondan a este impacto negativo y evaluar de forma escalonada el alcance de la ley en términos de competencias, especialidades y aumento de solicitudes.

Abstract The article analyzes the alternative methods of conflicto resolution-MASC in the face of the challenges and problematizations faced by the administration of alternative justice with the suppression of the conciliatory function of the family police stations in cases of domestic violence. The methodology is based on a documentary and bibliographic review regarding the constitutional and legal norms that regulate conciliation and the socio-legal impact that the regulations print in terms of access and judicial decongestion due to the decrease in institutions and officials empowered to conciliate in matters of domestic violence. The results indicate that the Political Constitution of 1991 consecrat ed an exceptional and transitory structure for the resolution of controversies through conciliation and this facilitates the protection of rights of a fundamental nature, but also of economic content. It is concluded that the elimination of the conciliatory function of the family police stations in cases of domestic violence reduces the effect of alternativemechanisms, making it necessary to create public policies that respond to this negative impact and evaluate in a staggered manner the scope of the law in terms of of skills, specialties and increase in applications.

Abstract From the framework of understanding young people as actors, subjects of law and autonomous, based on a Realist review of the literature we sought to collect information that would allow us to find strategies in Latin America to promote conscious consumption of alcohol in young people. Method: A search is made in databases and other sources. Results: After screening and selection, 13 documents were included. A theory of change was raised. Conclusions: Some strategies are identified with social participation and leisure as central elements both individually and collectively. It is recognized, how the autonomy and the potentiality of the subjects to act on themselves are the starting point to accompany the actions that young people carry out in the transformation of their own lives and that the strategies for the reduction of alcohol consumption in young people must allow him to recognize himself as a sociohistorical subject and an agent of change.

Resumen Desde el marco de comprensión de los jóvenes como actores, sujetos de derecho y autónomos, a partir de una revisión realista de la literatura, se buscó recolectar información que permitiera encontrar estrategias en América Latina para favorecer un consumo consciente de alcohol en jóvenes. Método: Se realiza búsqueda en bases de datos y otras fuentes. Resultados: Tras el cribado y selección se incluyeron 13 documentos. Se planteó una teoría de cambio. Conclusiones: Algunas estrategias se identifican con la participación social y el ocio como elementos centrales tanto en lo individual como en lo colectivo. Se reconoce, como la autonomía y la potencialidad de los sujetos para actuar sobre sí son el punto de partida para acompañar las acciones que los jóvenes realizan en la transformación de sus propias vidas y que las estrategias para la disminución del consumo de alcohol en jóvenes deben permitirle reconocerse como sujeto sociohistórico y agente de cambio.

Abstract Bariatric procedures have increased significantly in recent years, along with this increase are the complications associated, one of the most important being weight regain, which has traditionally been treated with changes in lifestyle and that when it fails it requires revisional surgery that presents high morbidity. Recently, endoscopic procedures have been described for weight regain after a bariatric procedure, which attempt to reduce the morbidity associated with revisional surgery while preserving the success rate. Argon plasma coagulation have the best results reported, and in this review we explore its indications, technique, and comparisons with other endoscopic techniques.

Resumen El número de procedimientos bariátricos ha aumentado de manera importante en los últimos años. A la par de este incremento se encuentra el número de complicaciones asociadas a ellos, siendo una de las más importantes la reganancia de peso, la cual tradicionalmente se ha tratado con cambios en el estilo de vida y que cuando falla requiere de la cirugía de revisión que presenta alta morbilidad. Recientemente se han descrito procedimientos endoscópicos para la reganancia de peso posterior a un procedimiento bariátrico que intentan disminuir la morbilidad asociada a la cirugía de revisión conservando la tasa de éxito. La coagulación con plasma de argón es una de las que mejores resultados ha presentado y en esta revisión exploramos sus indicaciones, técnica y las comparaciones con otras técnicas endoscópicas.

Resumo É descrito o caso de uma adolescente observada no Serviço de Urgência por retenção urinária, dor suprapúbica e disúria. Foi realizada urocultura devido a suspeita de cistite, que foi positiva para Escherichia Coli, e a rapariga foi medicada com amoxicilina e ácido clavulânico. Três dias depois, foi reavaliada por persistência da retenção urinária, febre e hemorragia vaginal. Ao exame ginecológico, apresentava um hímen imperforado. Foi realizada avaliação imagiológica, que detetou uma massa abdominal sugestiva de piohematocolpos, tendo sido realizada drenagem cirúrgica com resolução completa do quadro.

Abstract Herein is reported the case of a child observed in the Emergency Department due to urinary retention, suprapubic pain, and dysuria. Urine culture was performed upon cystitis suspicion, which was positive for Escherichia Coli, and the patient was treated with amoxicillin and clavulanic acid. Three days later, the child was reevaluated for persistent urinary retention, fever, and vaginal bleeding. At gynecological examination, she had an imperforate hymen. Imaging evaluation was performed, revealing an abdominal mass, suggestive of piohematocolpos. The patient was submitted to surgical drainage, with complete condition resolution.

Resumen La neuroeconomía es un campo multidisciplinar, que articula los conocimientos de áreas como la Economía, la psicología y la neurociencia, y que estudia el comportamiento cerebral en la toma de decisiones. A través de una revisión de literatura, se presenta la evolución de la investigación en neuroeconomía. Para ello, se emplean técnicas de mapeo científico, apoyadas en herramientas bibliométricas. La búsqueda, se realizó en las bases de datos WoS y Scopus, y la información obtenida fue procesada con las herramientas Bibliometrix y Gephi. Los documentos se clasificaron según su relevancia, en tres categorías: clásicos, estructurales y actuales. Luego, a través de un análisis de co-citaciones y clusterización, se identificaron y analizaron cinco líneas o corrientes de investigación en el área, a saber: elecciones económicas, elección social, consideraciones sobre la neuroeconomía, neurociencia del consumidor y comportamiento y estímulo cerebral. Se concluye con la necesidad de encontrar y estandarizar una metodología de investigación, en la que converjan los criterios para fortalecer los resultados de las investigaciones realizadas, ya que no se pueden desconocer las limitaciones de las metodologías actuales.

Abstract Neuroeconomics is a multidisciplinary field, which articulates the knowledge of areas such as economics, psychology and neuroscience, and which studies brain behavior in decision-making. Through a literature review, the evolution of research in neuroeconomics is presented. For this, scientific mapping techniques are used, supported by bibliometric tools. The search was carried out in the WoS and Scopus databases, and the information obtained was processed with the Bibliometrix and Gephi tools. The documents were classified according to their relevance, into three categories: classic, structural and current. Then, through an analysis of co-citations and clustering, five lines or currents of research in the area were identified and analyzed, namely: economic choices, social choice, considerations on neuroeconomics, consumer neuroscience and behavior and brain stimulation . It concludes with the need to find and standardize a research methodology, in which the criteria converge to strengthen the results of the research carried out, since the limitations of current methodologies cannot be ignored.

Resumen La Formación Tibasosa es la principal fuente de calizas en Boyacá. Esta unidad se depositó entre el Valanginiano-Albiano según el contenido fósil en la Cuenca Cordillera Oriental, registrando la primera incursión del mar Cretácico en Firavitoba. Los análisis de facies y estratigráficos de una sucesión carbonática-siliciclástica de ~12 m de espesor de la Formación Tibasosa Superior indican sistemas mareales/carbonáticos. Diez facies/microfacies se agruparon en dos asociaciones de facies (AFs): AF1, planicie mareal consiste en areniscas/limolitas laminadas y floatstones con un solo tipo de organismo dominante (conchas de bivalvos); y AF2 comprende rudstones, floatstones, packstones y wackstones, representando una plataforma carbonática. La descripción petrográfica determinó la textura/génesis y la secuencia diagenética con características de la eodiagénesis, mesodiagénesis y telodiagénesis sugiriendo un origen primario de estos carbonatos. El análisis mediante catodoluminiscencia (CL), espectrometría de energía dispersa (EDS) y microscopía electrónica de barrido (MEB) permitió identificar diferencias composicionales, fases de cementación y características morfológicas en diferentes procesos como micritización, neomorfismo, porosidad, piritización, compactación, cementación, fracturamiento. y meteorización. La interpretación de facies/microfacies indicó una deposición en una plataforma poco profunda con condiciones hidráulicas fluctuantes, aguas cálidas y eventos de tormentas/tsunamis que fragmentaron los bioclastos. Este sistema deposicional en la Cuenca Cordillera Oriental durante el Cretácico indica un gran evento transgresivo que inundó cientos de kilómetros, revelando conexión con el Océano Pacífico antes del levantamiento Andino. Los principales eventos diagenéticos corresponden a la micritización, cementación de calcita y compactación mecánica/química como resultado de la actividad microbiana, disolución, precipitación en la zona vadosa/freática y diagénesis de enterramiento. La secuencia diagenética revela la incidencia de procesos marinos y meteóricos que redujeron la porosidad y corroboran la actividad microbiana en el carbonato precipitado. Esta nueva interpretación permite comprender las plataformas carbonatadas en la Cuenca Cordillera Oriental para futuras correlaciones del mar Cretácico en Colombia.

Abstract The Tibasosa Formation is the main source of limestones in Boyacá. This unit corresponds to a Valanginian-Albian age according to the fossil content in the Eastern Cordillera Basin, recording the first incursion of the Cretaceous sea in Firavitoba. Outcrop-based facies and stratigraphic analyzes of the ~12 m-thick siliciclastic-carbonate succession of the uppermost Tibasosa Formation indicate tidal and carbonate systems. Ten facies/microfacies are grouped into two facies associations (FAs): FA1, tidal flat deposits consist of laminated sandstones/siltstones and floatstones with a single organism dominance (bivalve shells); and FA2 comprises fossiliferous rudstones, floatstones, packstones, and wackstones, representing a carbonate platform. The petrographic description determined rock textures/genesis and the diagenetic sequence with features of the eodiagenesis, mesodiagenesis, and telodiagenesis suggesting a primary origin of these carbonates. The analysis using cathodoluminescence (CL), energy disperse spectrometry (EDS), and scanning electron microscopy (SEM) allowed identify compositional differences, cementation phases, and morphological features in different processes as micritization, neomorphism, porosity, pyritization, compaction, cementation, fracturing, and weathering. The interpretation of facies and microfacies indicated a deposition mainly in a shallow platform with variation in the hydraulic conditions, warm waters, and episodic events of storms/tsunamis that fragmented the bioclasts. A shallow marine system in the Eastern Cordillera Basin during Cretaceous indicates a large transgressive event that flooded hundreds of kilometers, being a link with the Pacific Ocean before the Andes uplift. The main diagenetic events correspond to micritization, cementation of calcite, and mechanical/chemical compaction as a result of microbial activity, dissolution, precipitation in the vadose/phreatic zone, and burial diagenesis. The diagenetic sequence events reveal the incidence of marine and meteoric process that reduced porosity and attest to the microbial activity in carbonate precipitated. This new interpretation allows the understanding of carbonate platforms in the Eastern Cordillera Basin for future correlations of the Cretaceous sea in Colombia.

RESUMO Objetivo: Construir uma escala de atitudes dos adolescentes em face da sexualidade e determinar as suas caraterísticas psicométricas. Métodos: Estudo metodológico realizado com 394 alunos do 8º ao 12º ano de escolaridade de uma escola da região Centro de Portugal que responderam a um questionário constituído da Escala de Atitudes dos Alunos Adolescentes em face da Sexualidade e de dados sociodemográficos e acadêmicos. O projeto recebeu parecer favorável da Comissão Nacional de Proteção de Dados (autorização nº 10421/2017). Realizou-se a análise de validade do constructo, por análise fatorial exploratória, e de consistência interna, por alfa de Cronbach. Foi considerada probabilidade de erro máximo de 5%. Resultados: A média de idades da amostra foi de 14,9±1,4 anos, e 53,3% dos participantes eram do sexo feminino. O instrumento foi constituído de 34 itens distribuídos por cinco fatores: Fator 1. Planejamento familiar e educação sexual (α=0,826); Fator 2. Primeira relação sexual (α=0,819); Fator 3. Violação dos direitos sexuais e a quem recorrer na gravidez não planejada (α=0,695); Fator 4. Expressão e identidade de gênero (α=0,542); Fator 5. Gravidez não planejada e parentalidade (α=0,761). O valor do alfa total da escala foi 0,766, o que explica 45,3% da variância total. Conclusões: A adequação psicométrica da escala para a população portuguesa permite afirmar que se trata de um instrumento válido e confiável, que poderá ser utilizado em estudos futuros com o intuito de avaliar as atitudes dos alunos adolescentes em face da sexualidade.

ABSTRACT Objective: To construct a scale of adolescents' attitudes towards sexuality and to determine their psychometric characteristics. Methods: Methodological study conducted with 394 students from the 8th to 12th grades of a school in central Portugal. They answered a questionnaire consisting of the Adolescent Students' Attitude Scale for Sexuality (E3AS) and socio-demographic and academic data. The project received a favorable opinion from the National Data Protection Commission (authorization No. 10421/2017). Construct validity analysis was performed through exploratory factor analysis and internal consistency was performed through Cronbach's alpha. A maximum error probability of 5% was considered. Results: The mean age of the sample was 14.9±1.4 years, with 53.3% being female. The instrument consisted of 34 items distributed into five factors: F1. Family planning and sex education (α=0.826); F2. First sexual relationship (α=0.819); F3. Violation of sexual rights and who to turn to in the event of unplanned pregnancies (α=0.695); F4. Gender expression and identity (α=0.542), and F5. Unplanned pregnancy and parenting (α= 0.761), with a total alpha value of 0.766, accounting for 45.3% of total variance. Conclusions: The psychometric adequacy of the E3AS for the Portuguese population allows us to affirm that it is a valid and reliable instrument that can be used in future studies to assess the attitudes of adolescent students towards sexuality.

RESUMO Objetivo Caracterizar adolescentes referenciados à consulta médica a partir do instrumento de triagem Perfil de Saúde do Utente Adolescente e comparar as informações obtidas do questionário e os dados avaliados na consulta. Métodos Estudo retrospectivo e descritivo, com análise dos questionários preenchidos por adolescentes e respectivos processos clínicos da consulta realizada no período de janeiro de 2013 a junho de 2016. Resultados Foram consultados 54 adolescentes, 57% do sexo masculino, com média de idade 12±1,7 anos. No questionário, 37% responderam ter algum problema de saúde; 35% gostariam de mudar a relação com os pais; 18% tinham algum tipo de preocupação com a segurança na escola; e 39% cometiam erros alimentares. Aproximadamente 31% já tinham consumido álcool, 13% já tinham experimentado fumar, e 4% tinham experimentado outras drogas. Na primeira consulta, 38% dos respondentes responderam ter doença crônica, 11% referiram mau ambiente familiar, 39% apresentaram problemas escolares e 39% revelaram erros alimentares. Cerca de 13% experimentaram fumar, 24% consumiram álcool, e 2% experimentaram outras drogas. Foram referenciados à consulta de medicina do adolescente 37% dos adolescentes, e 39% foram direcionados a outra consulta hospitalar. Conclusão Em consulta, confirmaram-se muitos dos itens de risco biopsicossocial identificados por meio do questionário aplicado, o que pode indicar que este é um método útil no rastreio de problemática ligada à adolescência.

ABSTRACT Objective To characterize adolescents referred to medical consultation based on the screening tool “Perfil de Saúde do Utente Adolescente”, and to compare to information gathered from a questionnaire and data assessed during the visit. Methods A retrospective and descriptive study, with analysis of the questionnaires filled out by adolescents and their respective medical records, in the period from January 2013 to June 2016. Results A total of 54 adolescents were seen, 57% male and mean age of 12±1.7 years. In the questionnaire, 37% stated that they had some kind of health problem; 35% would like to change the relationship with their parents; 18% had some concern about safety at school; and 39% made dietary mistakes. Approximately 31% had consumed alcohol, 13% had tried smoking, and 4% had used other drugs. At the first medical appointment, 38% stated they had chronic disease, 11% reported poor family environment, 39% had school problems and 39% made dietary mistakes. About 13% had tried smoking, 24% had tried to consume alcohol, and 2% had tried other drugs. Thirty seven percent of adolescents were referred to adolescent medicine consultation, and 39% to another hospital consultation. Conclusion Many of the biopsychosocial risk items identified through the questionnaire were confirmed during consultation, indicating that it could be a useful screening method for problems linked to the adolescence period.