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The Care Block of Bogotá, Colombia, is an urban program that offers services for low-income unpaid caregivers. This study aimed to (i) characterize unpaid caregivers' subjective well-being, mental health symptoms, physical activity levels, and use of public spaces linked to the Care Block; (ii) identify caregivers' perceived built and social environment facilitators and barriers to accessing the Care Block facility; and (iii) document the community-led advocacy process to improve the Care Block program. The quantitative component included a subjective well-being and mental health symptoms survey, and the System for Observing Play and Recreation in Communities (SOPARC) instrument. The qualitative component included the Our Voice citizen science method augmented with portable virtual reality equipment to engage participants in advocacy for changes. Participants (median age of 53 years) dedicated a median of 13.8 h a day to unpaid caregiving, had an average subjective well-being score of 7.0, and 19.1% and 23.8% reported having depression and generalized anxiety symptoms respectively. Caregivers reported that the program fosters their perception of purpose, enjoyment, resilience, and cognitive and emotional awareness. SOPARC evaluation showed that most women engaged in moderate to vigorous physical activity. The caregivers highlighted education, physical activity services, and integration of facilities as facilitators to accessing the Care Block program. Poor quality and lack of sidewalks and roads, limited personal safety, and the risk of pedestrian-vehicle collisions were identified as barriers. Virtual Reality sparked compelling dialogue between participants and stakeholders, allowing stakeholders to reflect on an urban program facilitating unpaid care work.

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This study examined the effectiveness of a couple-based relationship education program, Within Our Reach. Secondary data (n = 3,609) were analyzed from the federal Supporting Healthy Marriage project. Couples were randomly assigned to receive Within Our Reach and associated services or to a no-treatment (treatment-as-usual) control group. Those assigned to Within Our Reach reported better couple and individual outcomes on 8 of 12 outcomes measured (M ES = .15) at the 12-month follow-up and 6 of 10 outcomes measured at the 30-month follow-up (M ES = .14), including higher relationship happiness, more warmth and support, more positive communication, less negative behavior and emotion, less psychological abuse, less physical assault (for men), lower psychological distress (for women), and less infidelity. They were also less likely to report that their marriage was in trouble. These effects were generally small in size and many were replicated across the two follow-ups. There were no significant differences between those assigned to Within Our Reach versus control on cooperative parenting, severe psychological assault, or percent married. Implications for future research, programming, and policy are discussed.

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Introducción: La biopsia por aspiración con aguja fna (BAAF), sigue siendo el procedimiento diagnóstco que permite establecer el diagnóstco de benignidado malignidad de los nódulos troideos. Con el propósito de estandarizar la descripción de los hallazgos citológicos de las BAAF, fue creado elsistema de Bethesda que consta de 6 categorías. El riesgo de malignidad en cada categoría varía con cada insttución. Este trabajo tene como propósitoestablecer la prevalencia de cáncer en cada categoría del sistema de Bethesda en nuestra insttución y comparar los resultados con lo reportado porla literatura.Diseño, lugar y partcipantes: revisión retrospectva de BAAF realizadas a pacientes con nódulos troideos palpables, que consultaron a nuestra insttucióndel 2012 al 2015. Todos los aspirados fueron reportados utlizando el sistema de Bethesda. La prevalencia de cáncer por categoría fue establecidacomparando el resultado de la BAAF con el diagnóstco histopatológico en los pacientes operados. En los pacientes no operados, el diagnóstco debenignidad fue establecido por un segundo aspirado benigno y no crecimiento por ultrasonido, en un período de seguimiento de por lo menos 6 meses.Resultados: se analizaron 181 BAAF, la prevalencia global de cáncer fue del 12%. La prevalencia de cáncer por categoría de Bethesda fue: 0% en categoríaI, 2.29% en categoría II, 0% en categoría III, 12.9% en categoría IV, 0% en categoría V y 100% en categoría VI.Conclusión: De acuerdo a nuestros resultados, la prevalencia de cáncer en las categorías I, III y V es menor; mientras que en las categorías II, IV y VIcoincide con lo reportado por otras insttuciones.(AU)

Introducton: Fine needle aspiraton biopsy (FNA) remains the best diagnostc tool that allows diagnosis of benign or malignant thyroid nodules. In orderto standardize the descripton of the cytological fndings of the FNA, Bethesda system, with 6 categories, was created. The risk of malignancy in eachcategory varies within each insttuton. This work aims to establish the prevalence of cancer in each category at our insttuton and compare it with theliterature.Design, setngs and subjects: Retrospectve study of FNAs performed on patents with palpable thyroid nodules from 2012 to 2015. All cytologies werereported using Bethesda system. The prevalence of cancer by category was established by comparing the results of the FNAs with histopathologicaldiagnosis in surgical patents. In non-surgical patents, benign diagnosis was established either with a second benign FNA and/or no growth by ultrasoundduring follow-up of at least 6 months.Results: We analyzed 181 FNA; the overall prevalence of cancer was 12%. The prevalence of cancer by category of Bethesda was 0% in Category I, CategoryII 2.29%, 0% in category III, 12.9% in category IV, V category 0% and 100% in category VI.Conclusions: According to our results, prevalence of cancer in categories I, III and V is less; whereas in categories II, IV and VI in our insttuton coincideswith prevalence published in other insttutons.

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Objetivo Explorar la relación de los actuales niveles de contaminación del aire en la ciudad para material particulado respirable (menor de 10 micras) PM10 y la consulta médica en población en edad productiva (18 a 65 años). Métodos Se revisaron los datos de la red de monitoreo de calidad del aire de la ciudad de Bogotá para los años 2008 y 2010, específicamente, niveles de PM10 y los diagnósticos de consultas médicas que fueron realizadas en hospitales públicos de la ciudad. Resultados De acuerdo con los resultados reportados por la red de monitoreo de calidad del aire de la ciudad, ha habido una disminución de 8 μg/m³ en el promedio anual de PM10 del año 2008 al año 2010, que equivale a un 11,9 % y aunque el número de consultas por motivos relacionados con contaminación atmosférica, aumentó del 2008 al 2010 en un 58,7 %, al comparar esta cifra con la cifra total de consultas médicas en cada año, se observa una disminución global de 1,2 %. Conclusiones Se evidencia que una importante proporción de las atenciones médicas generadas en la ciudad de Bogotá puede estar relacionada con su calidad del aire y que el conjunto de políticas de control que desde hace algún tiempo se vienen desarrollando en la ciudad han permitido lograr una reducción importante en los niveles de PM10.

Objective Exploring the relationship of current air pollution levels in Bogota for breathable particulate matter (<10 microns) PM10 and medical consultation during productive age (18 to 65 years old). Methods Data regarding Bogota's air quality monitoring network for 2008 to 2010 was reviewed, specifically PM10 levels and diagnosis arising from medical consultations in Bogota's public hospitals during this time. Results: According to the air quality monitoring network's results there was an 8 μg/m³ decrease in annual average PM10 from 2008 to 2010 (11.9 %) and, although consultations on grounds relating to air pollution increased by 58.7 % from 2008 to 2010, an overall 1.2 % decrease was observed when comparing this to the total of medical consultations each year. Conclusions A significant percentage of medical attention provided in Bogota may be related to its air quality; the set of control policies developed in Bogota for some time now have led to a significant reduction in PM10 levels.

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O autor interroga a relação entre o desastre totalitário e a psicanálise. Será que a psicanálise, os psicanalistas, tem algo pertinente a dizer acerca da barbárie? Esta não é uma dimensão que estaria fora do nosso campo? Será que podemos afirmar que o desastre que sobreveio na cultura não teria tido senão pouca ou nenhuma consequência sobre nossa "teoria", nossas "práticas", nossa "arte"? Não é incrível que demos seguimento à tarefa psicanalítica como se a onda da irrupção do terror e da barbárie na cultura não tivesse abalado as quatro paredes de nossos consultórios? Estas são perguntas que este artigo enfrenta e que levam o autor a se voltar sobre a questão dos estados limites a partir de sua reflexão acerca dos efeitos psíquicos duradouros do totalitarismo.

Malaise in civilization and totalitarian disaster. The author cross-examines the relationship between psychoanalysis and totalitarian disaster. Does psychoanalysis, psychoanalysts, have something relevant to say about the barbarism? Isn't this a dimension which is beyond our field? Can we say that the disaster that befell the culture would not have had but little or no consequence on our "theory", our "practice" our "art"? Isn't it amazing that we follow the psychoanalytic task as if the wave of eruption of terror and barbarism in culture had not shaken the four walls of our offices? These are questions which this article is facing, and leading the author to get back on the issue of borderline states since his reflection on the lasting psychological effects of totalitarianism.

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O autor interroga a relação entre o desastre totalitário e a psicanálise. Será que a psicanálise, os psicanalistas, tem algo pertinente a dizer acerca da barbárie? Esta não é uma dimensão que estaria fora do nosso campo? Será que podemos afirmar que o desastre que sobreveio na cultura não teria tido senão pouca ou nenhuma consequência sobre nossa "teoria", nossas "práticas", nossa "arte"? Não é incrível que demos seguimento à tarefa psicanalítica como se a onda da irrupção do terror e da barbárie na cultura não tivesse abalado as quatro paredes de nossos consultórios? Estas são perguntas que este artigo enfrenta e que levam o autor a se voltar sobre a questão dos estados limites a partir de sua reflexão acerca dos efeitos psíquicos duradouros do totalitarismo

Malaise in civilization and totalitarian disaster. The author cross-examines the relationship between psychoanalysis and totalitarian disaster. Does psychoanalysis, psychoanalysts, have something relevant to say about the barbarism? Isn't this a dimension which is beyond our field? Can we say that the disaster that befell the culture would not have had but little or no consequence on our "theory", our "practice" our "art"? Isn't it amazing that we follow the psychoanalytic task as if the wave of eruption of terror and barbarism in culture had not shaken the four walls of our offices? These are questions which this article is facing, and leading the author to get back on the issue of borderline states since his reflection on the lasting psychological effects of totalitarianism

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Se hace un pequeño recuento de la labor realizada por un grupo de médicos que a lo largo de la historia de las luchas independentistas cubanas, tanto en la colonia como más tarde en el enfrentamiento contra las dictaduras de Gerardo Machado y Fulgencio Batista hicieron importantes contribuciones al ejercicio de la profesión y también como combatientes revolucionarios. Se profundiza en la vida y la obra poco conocida del médico y botánico cubano del siglo XIX Sebastián Alfredo de Morales González quien fuera acusado de conspirador por sus ideales de libertad e independencia para la isla de cuba. El objetivo del trabajo es presentar una síntesis biográfica de algunos de estos médicos para agruparlas en un documento que sea de fácil acceso a estudiantes y profesores. Se concluye planteando la labor humana, revolucionaria y profesional de estas figuras que son paradigmas de la medicina cubana del siglo XIX y XX.

A small recount is made about a group of doctors who have made important contributions not only as professionals but as revolutionary fighters along the history of our country in the war of independence against the Spanish colony and later on against Gerardo Machado and Fulgencio Batista s dictatorships. We also made a careful study of the life and work of the Cuban Botanic and Doctor of the XIX century Dr. Sebastian Alfredo de Morales Gonzalez who was accused of conspiracy because of his ideas of freedom and independence for his island. The main objective of the work is to present a biographic synthesis of some of these doctors to group them together into a single document for easy access to students and professors. The work is concluded setting up the human, revolutionary and professional work of these figures who are a paradigm of the Cuban Medicine in the XIX and XX centuries.

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The composition of our diet partially reflects our body composition and from these it is possible to obtain some information about the quality of our feeding. However, the question may be, do we eat that we really need to eat? Or, why we eat what we eat? The human body is the result of the highly regulated expression of our genes, and our genetic heritage is the result of a constant evolutionary process of millions of years. Almost the totally of our genome was formed during the pre-agricultural era and we suppose that this is the optimal informational patrimony for the normal development of our life. This genetic patrimony has allowed our adaptation to the constant modifications of our environment, particularly to the climatic variations where our ancestors developed millions of years ago. Our genetic patrimony was slowly molded, without important changes, during each of the steps of the evolutionary process, from the Ardipithecus ramidus of arboreal life until the present Homo sapiens sapiens, determining our actual nutritional requirements. During these evolution steps aroused the "thrifty genotype" expressed as tissue leptin resistance and differential insulin resistance. At present the expression of the thrifty genotype is not necessary and the effects of its action are associated with the opulence diseases; obesity, cardiovascular diseases and diabetes, among others. This work discusses why we have reached to eat what we eat and how the evolution of our feeding can be related with diseases of high prevalence in the western world.

La composición de nuestra dieta refleja parcialmente nuestra composición corporal y de ello es posible obtener alguna información sobre la calidad de nuestra alimentación. Sin embargo, cabe la pregunta ¿comemos lo que deberíamos comer? o ¿porqué comemos lo que comemos? El organismo humano es el resultado de la expresión regulada de nuestros genes y nuestro patrimonio genético es el resultado de millones de años de un proceso evolutivo constante. La casi totalidad de nuestro genoma se formó durante la época pre-agrícola y suponemos que este es el patrimonio de información óptimo para el desarrollo normal de nuestra vida. Este patrimonio genético nos ha permitido adaptarnos a las modificaciones del medio ambiente, particularmente a las variaciones climáticas, en las que se desarrollaron nuestros antepasados hace millones de años atrás. Nuestro patrimonio informacional se fue moldeando lentamente, sin grandes cambios importantes, durante cada una de las etapas del proceso evolutivo desde el Ardipithecus ramidus de vida arbórea hasta el Homo sapiens sapiens actual, determinando así nuestros requerimientos nutricionales. Durante estas etapas evolutivas surgió el "gen ahorrador", expresado en una leptino resistencia e insulino resistencia diferencial en nuestros tejidos. Actualmente la expresión del gen ahorrador no es necesaria y los efectos de su acción están asociados con las enfermedades de la opulencia; la obesidad, las enfermedades cardiovasculares y la diabetes, entre otras. Este trabajo analiza el porqué hemos llegado a comer lo que comemos y como se relaciona la evolución de nuestra alimentación con las enfermedades de alta prevalencia en el mundo occidental.

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Neste artigo o autor busca conceituar a violência contemporânea mostrando as mais diferentes perspectivas com que ela aparece, inclusive o terrorismo e suas novas formas de expressão que utilizam os mais recentes desenvolvimentos da biologia, da bacterologia, da química e da física nuclear. A idéia central é de que a violência muda, mudam suas percepções e os comportamentos em realação a ela. No texto, além de uma contextualização histórica, são analisadas 1) as grandes transformações do mundo: o fim da Guerra Fria, a reestruturação produtiva e suas conseqüências para o declínio do movimento operário e a globalização e as novas formas de vitimização; 2) a seguir são apontadas as novas formas de abordagem e a caracterização de novos sujeitos, consonantes com a contemporaneidade.

In this paper, the author seeks to approach contemporary violence in its most different expressions, including the use of the most recent developments in biology, bacteriology, chemistry and nuclear physics. The central idea is that violence changes, and with it the way it is perceived and how we react to it. The text, besides putting violence into a historical context, analyzes 1) the big transformation(s) in the world: the end of the Cold War, the new industrial structure and its consequences for the decline of the labor movement, globalization and the new forms of victimization; 2) in the second part, the author points to new approaches and characterizes novel contemporary subjects.

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SUMMARY The follow up of a case of granulosa cell tumour in a mare through ultrasonography is reported. It has been observed a fast growth rate reaching its final size around 18 days. The diagnostic of granulosa cell tumour was confirmed by gross and histopathologic examination, after surgical removal.

RESUMO Descreve-se o acompanhamento clínico de um caso de tumor de células da granulosa na égua através da ultra-sonografia. Foi constatada uma evolução rápida durante 18 dias para o tumor confirmado, pelo exame macroscópico e histopatológico, após remoção cirúrgica.

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SUMMARY The follow up of a case of granulosa cell tumour in a mare through ultrasonography is reported. It has been observed a fast growth rate reaching its final size around 18 days. The diagnostic of granulosa cell tumour was confirmed by gross and histopathologic examination, after surgical removal.

RESUMO Descreve-se o acompanhamento clínico de um caso de tumor de células da granulosa na égua através da ultra-sonografia. Foi constatada uma evolução rápida durante 18 dias para o tumor confirmado, pelo exame macroscópico e histopatológico, após remoção cirúrgica.