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The paper presents data on the U–Pb chronology of detrital zircon grains and radiogenic isotopic composition (87Sr/86Sr, ɛNd) from the Proterozoic clastic successions of the Garhwal‐Kumaon Lesser Himalaya representing the extended northern Indian cratonic margin, NW India. The Proterozoic Lesser Himalayan Basin in Garhwal‐Kumaon Himalaya is divided into two sectors, namely, Inner Lesser Himalaya (ILH) and Outer Lesser Himalaya (OLH) by a tectonic boundary, namely the Tons Thrust (TT). Age distribution from inner and outer sectors of the Lesser Himalaya shows that the U–Pb chronology of most of these zircons provides Palaeoproterozoic (between 1.6 and 1.8 Ga) to Neoproterozoic (800 Ma) ages. The age data suggest sedimentation of the Rautgara Formation (Damtha Group) of ILH continued till the Neoproterozoic (~850 Ma), which was earlier regarded as ≤1.6 Ga. Tracking the detrital U–Pb zircon ages in the near adjacent cratonic parts point towards Aravalli Orogen as the major source region. Whole‐rock ƐNd(0) values for ILH rocks range from −37.6 to −14.6 and for OLH it ranges from −19.6 to −6.7. More negative ƐNd values along with dominance of Neoarchean‐Palaeoproterozoic ages in ILH indicates supply from more evolved protolith or recycled sources and less negative ƐNd values with major Neoproterozic zircon ages from OLH supports for less evolved source rock. The change from more negative ƐNd to less negative ƐNd values progressively upward the stratigraphy can be due to a shift in source with time. Both U–Pb zircon and ƐNd supports for a continuous sedimentation model, rule out the presence of ~500 Ma unconformity within the LH and argues for separate evolution of the Lesser Himalayan Basin on the trailing edge of the extended north Indian craton in "Columbia" configuration. [ABSTRACT FROM AUTHOR]

Copyright of Colombia Medica is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

One of the major goals of family planning programs worldwide has been to reduce the level of fertility in hopes of slowing the rate of natural increase and promoting social and economic development. Such programs have now been in existence for sufficient lengths of time to have had an impact on fertility levels. In general countries with organized family planning programs, marked declines in fertility levels have been observed. The extent to which such declines may be credited to organized programs has not been rigorously measured because an appropriate research methodology has been lacking. This paper describes one method of directly linking declines in fertility levels to the contraceptive protection experienced by a population. The contribution of organized family planning programs is estimated by decomposing the amount of total contraceptive protection into within-program and outside-program sources. [ABSTRACT FROM AUTHOR]

Copyright of Colombia Medica is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In Colombia, cancer incidence is increasing, as is the demand for end-of-life care. Understanding how patients who die from cancer experience this phase will allow the identification of factors associated with greater suffering and actions to improve end-of-life care. We aimed to explore associations between the level of suffering of patients who died from cancer and were cared for in three Colombian hospitals with patient, tumor, treatment, and care characteristics and provided information. Methods: Data on the last week of life and level of suffering were collected through proxies: Bereaved caregivers of patients who died from cancer in three participating Colombian hospitals. Bereaved caregivers participated in a phone interview and answered a series of questions regarding the last week of the patient's life. An ordinal logistic regression model explored the relationship between the level of suffering reported by bereaved caregivers with the patient's demographic and clinical characteristics, the bereaved caregivers, and the care received. Multivariate analyses were adjusted for place of death, treatments to prolong of life, prolongation of life during the dying process, suffering due to prolongation of life, type of cancer, age, if patient had partner, rural/urban residence of patient, importance of religion for the caregiver, caregivers´ relationship with the patient, and co-living with the patient. Results: A total of 174 interviews were included. Median age of the deceased patients was 64 years (IQR 52–72 years), and 93 patients were women (53.4%). Most caregivers had rated the level of suffering of their relative as "moderately to extremely" (n = 139, 80%). In multivariate analyses, factors associated with a higher level of suffering were: unclear information about the treatment and the process before death Odds Ratio (OR) 2.26 (90% CI 1.21–4.19), outpatient palliative care versus home care OR 3.05 (90% CI 1.05–8.88), procedures inconsistent with the patient's wishes OR 2.92 (90% CI 1.28–6.70), and a younger age (18–44 years) at death versus the oldest age group (75–93 years) OR 3.80 (90% CI 1.33–10.84, p = 0.04). Conclusion: End-of-life care for cancer patients should be aligned as much as possible with patients´ wishes, needs, and capacities. A better dialogue between doctors, family members, and patients is necessary to achieve this. [ABSTRACT FROM AUTHOR]

Copyright of Lecturas de Economia is the property of Universidad de Antioquia, Facultad de Ciencias Economicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The present study analyzes inequalities in catastrophic health expenditures in conflict-affected regions of Meta, Colombia and socioeconomic factors contributing to the existence and changes in catastrophic expenditures before and after the sign of Colombian Peace Agreement with FARC-EP guerilla group in 2016. Methods: The study uses the results of the survey Conflicto, Paz y Salud (CONPAS) conducted in 1309 households of Meta, Colombia, a territory historically impacted by armed conflict, for the years 2014 and 2018. We define catastrophic expenditures as health expenditures above 20% of the capacity to pay of a household. We disaggregate the changes in inequalities in catastrophic expenditures through the Oaxaca-Blinder change decomposition method. Results: The incidence of catastrophic expenditures slightly increased between 2014 to 2018, from 29.3 to 30.7%. Inequalities in catastrophic expenditures, measured through concentration indexes (CI), also increased from 2014 (CI: -0.152) to 2018 (CI: -0.232). Results show that differences in catastrophic expenditures between socioeconomic groups are mostly attributed to an increased influence of specific sociodemographic variables such as living in rural zones, being a middle-aged person, living in conflict-affected territories, or presenting any type of mental and physical disability. Conclusions: Conflict-deescalation and the peace agreement may have facilitated lower-income groups to have access to health services, especially in territories highly impacted by conflict. This, consequently, may have led to higher levels of out-of-pocket expenditures and, therefore, to higher chances of experiencing catastrophic expenditures for lower-income groups in comparison to higher-income groups. Therefore, results indicate the importance of designing policies that guarantee access to health services for people in conflict -affected regions but also, that minimize health care inequalities in out-of-pocket payments that may arouse between people at different socioeconomic groups. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cuidarte is the property of Universidad de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To analyze the relationship between rural and urban homicide rates in Colombia between 1992 and 2015 and the fluctuations in these rates. Methods. Individual records of homicides and population aggregates in men and women aged 15-64 years were used. The adjusted rates of annual homicides were calculated for urban/rural areas and standardized by age. Rate Ratios (RRs) adjusted by region were calculated. A joinpoint analysis was performed to identify inflection points and the Annual Percentage Change (APC). Results. Four joinpoints were identified in rural and urban rates: after peaking in 1992, homicide rates fell until 1997, and then increased until 2002. From this point on there was a continuous reduction until 2015, although this reduction slowed down from 2005 onward. During almost the whole period, the rates of rural homicides were higher than those of urban homicides, although they equalized at the end of the period. Conclusions. Unlike in other countries, during the study period Colombian homicide rates, which coincided with the dynamics of the armed conflict, were higher in rural than in urban areas. In recent years, a predominance of urban homicides committed by younger men has been identified, which could pose a challenge to postconflict in Colombia. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country.Method: We conducted a cross-sectional study in 177 children (ages 2-12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012-2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations.Results: There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27-14.0) and stunting (OR 8.42; 95% CI 2.90-24.4) than those classified in GMFCS levels I to III.Interpretation: Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction. [ABSTRACT FROM AUTHOR]

An analysis of marital histories from World Fertility Survey data in Colombia, Panama, and Peru indicates a high level of union dissolution: the probabilities of a first union ending by separation within twenty years of the onset of union equal .27, .40, and .18 in the three countries respectively. Dissolution probabilities are especially high among women with young ages at first union and among women residing in urban areas. For all subgroups studied, consensual unions are characterized by several times the risk of separation of legal marriages. Consensual unions are especially frequent among women in rural areas, women with little education and women who enter unions at young ages. The different prevalence of consensual unions among the different subgroups affects the associations between union stability and various correlates so that it becomes essential to investigate the factors affecting union stability for both consensual unions and legal marriages. In spite of high dissolution rates, remarriage rates in all three countries are also high, as are the percentages of time spent in a union. Hence, the potential effects of voluntary disruption of unions on fertility appear to be modest. [ABSTRACT FROM AUTHOR]