José Rafael Tovar Cuevas

Introduction: Waiting time is a key performance indicator determining the quality and timeliness of the emergency department (ED). Objective: In this research, a model to predict waiting times from triage to medical consultation in ED was designed, considering the patient priority, the place of medical care, and the reason for consultation by time slot and weekdays. This paper also predicted patient average in triage, admission, and medical consultation queues. Method: A discrete event simulation model was developed using a colored Petri net (CPN) framework, representing the detailed process and patient flows in ED. Next, the model was simulated in CPN Tools software and validated with historical data. Finally, the model experimented with several scenarios between patients' arrival rates and initial system load conditions (ED congestion). Results: The simulation provided helpful information for patients once they arrive at the ED and Emergency Medical System, as it must choose the hospital with the shorter waiting times for transferring patients by ambulance from the scene. Moreover, predicting waiting times would contribute to integrating the health system's stakeholders (EDs, ambulances, and emergency medical dispatch centers). Conclusions: This model presented a deeper detail, considering more specific patient characteristics than the literature showed. Furthermore, the predicted average waiting times considered more factors associated with the patient, time, and ED congestion than the average or some percentiles according to patient triage.

Introduction. Dengue is an endemic disease in Colombia, with spatial variations influenced by climatic, socioeconomic, and basic service access factors. Territorial characterization based on these determinants supports a better understanding of disease distribution and enables the design of more effective control strategies.Objectives. To identify groups of departments in Colombia based on the relationship between dengue incidence rates and climatic, socioeconomic, and basic service access factors in 2023.Materials and methods. Data were collected from the Instituto Nacional de Salud of Colombia, the Encuesta Nacional de Calidad de Vida, and satellite sources, such as ERA5 and CHIRPS. Variables related to access to basic services (drinking water, sewage, and waste collection), housing deficit, temperature, precipitation, and the normalized difference vegetation index (NDVI) were analyzed. A multiple factor analysis was applied to reduce dimensionality, followed by hierarchical clustering and self-organizing maps to identify department groupings.Results. Three groups of departments with distinct characteristics were identified. The most vulnerable group (group 3) showed an average incidence rate of 1,046.87 cases per 100,000 inhabitants, associated with extreme housing deficits, limited access to basic services, and climatic conditions favorable for vector proliferation.Conclusions. The analysis identified key territorial patterns in dengue incidence and highlighted the influence of structural factors on disease transmission. These findings provide a foundation to strengthen public policies and design more targeted prevention and control strategies in the most vulnerable regions.

[Objective]: This research aimed to identify and analyze topics in the scientific literature related to dengue, with a focus on diagnosis, signs, and symptoms using the Latent Dirichlet Assignment (LDA) model. [Methodology]: Articles were collected from various databases, including VHL, Web of Science, Ovid, Scopus, PubMed, Health & Medical, ScienceDirect, and Google Scholar, covering 2000-2024. The search equation was designed using key terms such as “dengue,” “signs,” “symptoms,” and “diagnosis,” along with MeSH terms to ensure the inclusion of relevant articles. The LDA model was then implemented to analyze the collected articles. [Results]: The implementation of the LDA model identified four main themes: 1) Dengue diagnosis and clinical presentation, 2) Research and control interventions, 3) Severe dengue and its clinical manifestations, and 4) Virus detection, including dengue, zika, and chikungunya. This thematic analysis facilitated the organization and understanding of literature, providing an overview of the predominant themes in dengue research. [Conclusions]: The study’s approach not only enhanced the organization and understanding of the articles found but also provided insights into the predominant themes in dengue literature, which may guide future research and improve diagnostic and treatment strategies.

En este artículo se propone una aproximación heurística para medir el nivel de preocupación y un modelo que predice la probabilidad de aprobar el primer curso de matemáticas en la universidad. Se utilizó una La metodología cuantitativa centrada en el uso de estadística inferencial. Se aplicó un instrumento tipo encuesta con preguntas cerradas a 502 estudiantes de primer semestre matriculados en diferentes carreras de una universidad privada en Cali-Colombia. Los resultados permiten contar con un indicador que aproxima los niveles de preocupación frente a la asignatura de matemáticas que presentan los estudiantes de carreras diferentes a la de matemáticas cuando van a tomar su primer curso de esta disciplina en la universidad. La probabilidad de reprobar el curso aumenta con el incremento de los niveles de preocupación y cuando se ha dejado transcurrir mucho tiempo entre la salida del colegio y el ingreso a la universidad. Se concluye que los niveles de preocupación inicial frente al curso pueden ser funcionales, pero no necesariamente patológicos. El modelo de probabilidad propuesto puede ser una herramienta útil para que los profesores identifiquen las condiciones iniciales en las que llegan los estudiantes al curso y usen esta información como insumo para su planificación.

BACKGROUND Previous investigations related to the factor structure of the Patient Health Questionnaire (PHQ-9) have yielded inconclusive results, and there is little consensus about the optimal arrangement of its components. OBJECTIVE This study aim to examine the psychometric properties of the nine-item Patient Health Questionnaire (PHQ-9) in a sample of long-term survivors of severe COVID-19. METHODS The PHQ-9 was administered to 177 patients who were categorized as having suffered previous severe COVID-19 and were followed up to 20 months after this event. Exploratory and confirmatory factor and reliability analyses were performed. RESULTS The one-factor model of PHQ-9 was determined to best fit the sample and demonstrated good psychometric properties and high internal consistency. The factor loadings for the two-factor structure were not consistent with theoretical frameworks of depression and demonstrated lower internal consistency. Subsequent confirmatory analysis indicated a good model fit for the one-factor model CONCLUSIONS The single-factor PHQ-9 was shown to be a valid and reliable instrument for assessing depression in the current sample of patients with history severe COVID-19, followed up to 20 months after this event

En este artículo se propone una aproximación heurística para medir el nivel de preocupación y un modelo que predice la probabilidad de aprobar el primer curso de matemáticas en la universidad. Se utilizó una La metodología cuantitativa centrada en el uso de estadística inferencial. Se aplicó un instrumento tipo encuesta con preguntas cerradas a 502 estudiantes de primer semestre matriculados en diferentes carreras de una universidad privada en Cali-Colombia. Los resultados permiten contar con un indicador que aproxima los niveles de preocupación frente a la asignatura de matemáticas que presentan los estudiantes de carreras diferentes a la de matemáticas cuando van a tomar su primer curso de esta disciplina en la universidad. La probabilidad de reprobar el curso aumenta con el incremento de los niveles de preocupación y cuando se ha dejado transcurrir mucho tiempo entre la salida del colegio y el ingreso a la universidad. Se concluye que los niveles de preocupación inicial frente al curso pueden ser funcionales, pero no necesariamente patológicos. El modelo de probabilidad propuesto puede ser una herramienta útil para que los profesores identifiquen las condiciones iniciales en las que llegan los estudiantes al curso y usen esta información como insumo para su planificación.

The pandemic generated multiple biopsychosocial challenges that significantly impacted the health of trans women. The aim of this study is to characterize emotional states and resilience in trans women in Colombia and their relationship to COVID-19 adherence behaviors and prevention behaviors during lockdown. The study employed a cross-sectional descriptive correlational design, with an anonymous online questionnaire that was given to 100 trans women in five cities in Colombia. During the pandemic, more than half of trans women experienced negative emotional states such as depression, anxiety and somatization, and some positive ones such as resilience and personal growth. The latter two contribute to reinforcing adherence and prevention behaviors. This study demonstrates a clear need to give priority and recognition to trans women and their health needs, in order to protect their rights, their well-being, and their health.