Satisfaction with and use of inhalation devices in patients with bronchial asthma v1

Introduction:Greater patient satisfaction with his or her inhalation device is associated with better adherence to pharmacological therapy and better clinical outcomes, such as improved quality of life, greater asthma control and fewer exacerbations. Objective: To determine the satisfaction level of a group of patients diagnosed with bronchial asthma with respect to their devices for inhalation of bronchodilators and glucocorticoids. Methods: This was a cross-sectional study of patients treated in the Colombian health system. Satisfaction with inhalation devices was evaluated with the FSI-10 instrument (Evaluation of Satisfaction with the Inhaler). A score of ≥ 44 points indicated high satisfaction. Results: In total, 362 patients from 59 cities were identified, their median age was 55 years, and 74.6% were women. The average score was 44.6; 68.5% of patients showed high satisfaction, especially with metered-dose inhalers, and 63.4% did not use them with an inhalocamera. Users of metered-dose inhalers (OR: 1.80; 95% CI: 1.05–3.10) and those who received training by medical specialists (OR: 2.29; 95% CI: 1.33–3.97) had high satisfaction, while patients who were older (40–64 vs. <40 years: OR: 0.38; 95% CI: 0.19–0.78 and ≥ 65 vs. <40 years: OR: 0.35; 95% CI: 0.15–0.81), resided in the Caribbean region (OR: 0.48; 95% CI: 0.29–0.81) and had a university education (OR: 0.54; 95% CI: 0, 32–0.90) had lower satisfaction. Conclusions: The majority of patients with asthma used metered-dose inhalers without an inhalocamera, and their overall satisfaction was higher than that of patients using other inhalation devices. Patients who received special training from medical specialists showed better satisfaction.

Confirmation of the current occurrence of Nasua narica (Procyonidae) in the Caribbean region of Colombia

The White-nosed Coati, Nasua narica is a small carnivore distributed from the United States to Ecuador, and whose occurrence in Colombia had only been confirmed from the biogeographic Chocó. Although it was previously erroneously considered widespread in the country, a recent revision identified inconsistencies with some supporting records there. Here we present a new distribution record for the species, which confirms previously alleged information about the presence of this procyonid in the Department of Magdalena, also confirming its current occurrence for the Caribbean region, and solving a long-due geographical distribution uncertainty in the country.

Comparative genomics of the black rot pathogen Xanthomonas campestris pv. campestris and non-pathogenic co-inhabitant Xanthomonas melonis from Trinidad reveal unique pathogenicity determinants and secretion system profiles

Black-rot disease caused by the phytopathogen Xanthomonas campestris pv. campestris (Xcc) continues to have considerable impacts on the productivity of cruciferous crops in Trinidad and Tobago and the wider Caribbean region. While the widespread occurrence of resistance of Xcc against bactericidal agrochemicals can contribute to the high disease burdens, the role of virulence and pathogenicity features of local strains on disease prevalence and severity has not been investigated yet. In the present study, a comparative genomic analysis was performed on 6 pathogenic Xcc and 4 co-isolated non-pathogenic Xanthomonas melonis (Xmel) strains from diseased crucifer plants grown in fields with heavy chemical use in Trinidad. Native isolates were grouped into two known and four newly assigned ribosomal sequence types (rST). Mobile genetic elements were identified which belonged to the IS3, IS5 family, Tn3 transposon, resolvases, and tra T4SS gene clusters. Additionally, exogenous plasmid derived sequences with origins from other bacterial species were characterised. Although several instances of genomic rearrangements were observed, native Xcc and Xmel isolates shared a significant level of structural homology with reference genomes, Xcc ATCC 33913 and Xmel CFBP4644, respectively. Complete T1SS hlyDB, T2SS, T4SS vir and T5SS xadA, yapH and estA gene clusters were identified in both species. Only Xmel strains contained a complete T6SS but no T3SS. Both species contained a complex repertoire of extracellular cell wall degrading enzymes. Native Xcc strains contained 37 T3SS and effector genes but a variable and unique profile of 8 avr, 4 xop and 1 hpa genes. Interestingly, Xmel strains contained several T3SS effectors with low similarity to references including avrXccA1 (~89%), hrpG (~73%), hrpX (~90%) and xopAZ (~87%). Furthermore, only Xmel genomes contained a CRISPR-Cas I-F array, but no lipopolysaccharide wxc gene cluster. Xmel strains were confirmed to be non-pathogenic by pathogenicity assays. The results of this study will be useful to guide future research into virulence mechanisms, agrochemical resistance, pathogenomics and the potential role of the co-isolated non-pathogenic Xanthomonas strains on Xcc infections.

Co-learning during the co-creation of a dengue early warning system for the health sector in Barbados

Over the past decade, the Caribbean region has been challenged by compound climate and health hazards, including tropical storms, extreme heat and droughts and overlapping epidemics of mosquito-borne diseases, including dengue, chikungunya and Zika. Early warning systems (EWS) are a key climate change adaptation strategy for the health sector. An EWS can integrate climate information in forecasting models to predict the risk of disease outbreaks several weeks or months in advance. In this article, we share our experiences of co-learning during the process of co-creating a dengue EWS for the health sector in Barbados, and we discuss barriers to implementation as well as key opportunities. This process has involved bringing together health and climate practitioners with transdisciplinary researchers to jointly identify needs and priorities, assess available data, co-create an early warning tool, gather feedback via national and regional consultations and conduct trainings. Implementation is ongoing and our team continues to be committed to a long-term process of collaboration. Developing strong partnerships, particularly between the climate and health sectors in Barbados, has been a critical part of the research and development. In many countries, the national climate and health sectors have not worked together in a sustained or formal manner. This collaborative process has purposefully pushed us out of our comfort zone, challenging us to venture beyond our institutional and disciplinary silos. Through the co-creation of the EWS, we anticipate that the Barbados health system will be better able to mainstream climate information into decision-making processes using tailored tools, such as epidemic forecast reports, risk maps and climate-health bulletins, ultimately increasing the resilience of the health system.

Epidemiological study of Colletotrichum spp. associated with Enterolobium cyclocarpum (Jacq.) Griseb. and Platymiscium pinnatum (Jacq.) Dugand in the Colombian Caribbean Region

Epidemiological analyzes of foliar diseases associated with Colletotrichum spp. in Enterolobium cyclocarpum and Platymiscium pinnatum were performed under field conditions and without any type of intervention. At the Universidad del Magdalena (Santa Marta, Colombia), four trees for each species and four equidistant monitoring sites per tree were established. The incidence and severity were recorded for 33 weeks (March to November 2016), including two follow-up periods: dry and rainy season. Disease development curves were elaborated. Moreover, the development rate (r) and the area under the disease progress curve (AUDPC) were calculated for each follow-up period. The effect of the meteorological variables was statistically analyzed by correlation and multiple regression. In E. cyclocarpum, the highest incidence and severity were recorded between September and November with 100 and 19.6%, respectively, showing a positive correlation with relative humidity and negative with average temperature, solar radiation and wind speed. In P. pinnatum, the maximum values of incidence and severity were observed between March and April with 68.9 and 1.3%, respectively. However, correlation analyzes did not support their relationship with the environmental factors. The r values during the dry months were 0.136 and 0.107 units week-1 and the AUDPCs were calculated at 51 and 4 units week-1 for E. cyclocarpum and P. pinnatum, respectively. In the rainy months, the r values were 0.187 and 0.016 units week-1 and the AUDPCs were 186 and 2 units week-1, respectively. In conclusion, the development of the disease varies according to the forest species, time of year and some meteorological variables.

Silvopastoral and conventional management of extensive livestock and the diversity of bats in fragments of tropical dry forest in Córdoba, Colombia

The establishment of extensive livestock systems in the Colombian Caribbean Region has historically generated a strong loss of the tropical dry forest (TDF) with negative effects on biodiversity. Currently, the implementation of silvopastoral systems (SPS) has been proposed with strategy to curb the loss of biodiversity caused by the conventional management system (CS). The objective was to evaluate the effect of SPS and CS of extensive livestock on the assemblage of bats associated with fragments of TDF. During a continuous year and a sampling effort of 30,240 h-net/night, the structure and composition of bat assemblage between SPS and CS were compared. 2788 bats belonging to six families, 23 genera, and 39 species were captured. The Phyllostomidae family presented the highest species richness (S = 30), with the greatest abundance in the Stenodermatinae subfamily (n = 1543). Bat assemblage in the SPS fragments was more equitable; and the relative abundance per species, per genera, and per foraging guilds was also significantly higher. The capture success showed significant variations between the climatic seasons (dry and rainy). The rate of species turnover was higher in the CS fragments. The species Artibeus planirostris, Artibeus lituratus, Carollia perspicillata, Carollia castanea, Phyllostomus discolor, Dermanura phaeotis, Uroderma convexum, Glossophaga soricina, C. brevicauda, and Sturnira lilium accounted for 92% of the captures. In conclusion, frugivorous bats were more abundant in the SPS, type of extensive livestock management that can generate greater temporal stability of bat assemblage. This research provides the first scientific evidence of the positive effect of silvopastoral management on the diversity of bats in tropical dry forest areas of the Colombian Caribbean region.

Connectivity conservation at the crossroads: protected areas versus payments for ecosystem services in conserving connectivity for Colombian carnivores

Protected areas (PAs) constitute one of the main tools for global landscape conservation. Recently, payments for environmental services (PES) have attracted interest from national and regional governments and are becoming one of the leading conservation policy instruments in tropical countries. However, the degree to which areas designated for PES overlap with areas that are critical for maintaining species' landscape connectivity is rarely evaluated. We estimated habitat distributions and connectivity for 16 of the 22 mammalian carnivores occurring in the Caribbean region of Colombia, and identified the overlap between existing PAs and areas identified as being important for connectivity for these species. We also evaluated the potential impact of creation of new PAs versus new PES areas on conserving connectivity for carnivores. Our results show that PAs cover only a minor percentage of the total area that is important for maintaining connectivity ( x = 26.8 % ± 20.2 s . d . ). On the other hand, PES, if implemented extensively, could contribute substantially to mammalian carnivores’ connectivity ( x = 45.4 % ± 12.8 s . d . ). However, in a more realistic scenario with limited conservation investment in which fewer areas are set aside, a strategy based on implementing new PAs seems superior to PES. We argue that prioritizing designation of new PAs will be the most efficient means through which to maintain connectivity.

Fermentation Parameters of Suero Costeño Elaborated with Lactic Acid Bacteria Strains

Studying the fermentation parameters of "Suero Costeño" was the focus of this research, considered a traditional product in the Caribbean region of Colombia, inoculated with lactic acid bacteria Lactococcus lactis subsp. Lactis (ATCC29146) and Lactobacillus paracasei subsp. paracasei (ATCC 334). It was found that the percentage of lactose decreased progressively during the hours of fermentation, with a minimum lactose value of 3.1% at 15 h for the samples of Suero Costeño with L. lactis, while for L. paracasei the percentage of lactose was 3.4%. L. paracasei the percentage of lactose was 3.4%; on the other hand, the pH, which is a limiting factor in the fermentation process, was reported to have a considerable reduction in the samples with L. lactis in comparison with L. paracasei, at the end of the fermentation process at 15 h, with values of 4.3 and 4.5, respectively. Finally, the sensory evaluation allowed establishing that the Suero Costeño with L. lactis obtained similar values to that produced in a traditional way, and therefore its use can be recommended in this type of dairy products as a starter culture.