Binge drinking associated with mean temperature: a cross-sectional study among Mexican adults living in cities.

BACKGROUND: The association between environmental temperature and alcohol consumption has not been widely explored despite the potential that increasing temperatures could promote the consumption of alcoholic beverages and the alcohol-related burden of disease. We aimed to explore the association between temperature and binge drinking in Mexican adults from urban cities, overall, and by alcoholic beverage type. METHODS: Data on 10,552 adults ≥ 18 years was obtained from the 2016 National Survey on Drug, Alcohol, and Tobacco Consumption. The mean annual temperature at the municipality was obtained from the Mexican National Weather Service using monthly temperatures from 2015 to 2016. We analyzed binge drinking for all alcoholic beverages in the last year and by type of alcohol as beer, liquor, wine, and coolers. Associations between mean temperature over the past year and binge drinking over the past year among current drinkers were estimated using multilevel Poisson models with robust standard errors adjusted for age, sex, education level, marital status, and household socioeconomic status, with a fixed effect by region. RESULTS: We observed a non-significant increase in the prevalence of binge drinking for every difference of 1 °C between municipalities of the same region. By alcohol type, a 1 °C increase in mean annual temperature across municipalities of the same region increased the prevalence of beer binge drinking in the past year by 0.9% (PR = 1.009, 95%CI 1.005, 1.013) among beer consumers and the prevalence of coolers' binge drinking by 3.0% (PR = 1.030, 95%CI 1.003, 1.057) in coolers consumers. We observed non-significant results for liquor binge drinking (PR = 1.047, 95%CI 0.994, 1.102) and wine binge drinking (PR = 1.047, 95% 0.944, 1.161). CONCLUSION: People living in municipalities with higher temperatures reported a higher beer binge drinking in Mexican cities. This could account for 196,000 cases of beer binge drinking in 2016. The context of each country needs to be considered when generalizing these findings, and they need to be further explored with longitudinal data as there might be implications for climate change. If our findings are confirmed given the forecasted rising temperatures, we could expect an increase in binge drinking and therefore, in the alcohol burden of disease.

Impact of an enhanced sobriety checkpoints programme and publicity campaign on motor vehicle collisions, injuries and deaths in Leon, MX: a synthetic control study.

OBJECTIVE: Drunk driving is a major cause of road traffic injuries and deaths in Latin America. We evaluated the impact of a drunk driving intervention in Leon, Mexico on road traffic safety. METHODS: The intervention included increased drunk driving penalties, enhanced sobriety checkpoints and a young adult-focused mass media campaign, beginning 19 December 2018. We created a synthetic control Leon from 12 Mexican municipalities from a pool of 87 based on similarity to Leon using key predictors from 2015 to 2019. We assessed the effect of the intervention on road traffic collisions overall and collisions with injuries, deaths and involving alcohol, using data from police, insurance claims and vital registration. RESULTS: As compared with the synthetic control, Leon experienced significant postintervention lower police-reported total collision rate (17%) and injury collisions (33%). Alcohol-involved collisions were 38% lower than the synthetic control. Fatal collisions reported by police were 28% lower while vital registration road traffic deaths were 12% lower, though these declines were not statistically significant. We found no impact on insurance collision claims. There was heterogeneity in these changes over the evaluation year, with stronger initial effects and weaker effects by the end of the year. CONCLUSIONS: Drunk driving policies in Leon led to fewer traffic collisions and injuries during the first year of implementation, with a weakening of this effect over time, similar to interventions in high-income settings and other Latin American countries. Supporting the expansion of similar policies to other cities in the region could improve road safety.

Dietary patterns in Mexican children and adolescents: Characterization and relation with socioeconomic and home environment factors.

BACKGROUND: Eating habits in children and adolescents are influenced by multiple determinants, which include socioeconomic and home environmental factors. OBJECTIVE: To characterize the dietary patterns in Mexican children and adolescents and to assess its association with socioeconomic and home environmental factors. METHODS: A cross-sectional study was conducted in 878 children and adolescents aged 5-15 years, unrelated, selected randomly from Morelos Sports Unit at north of Mexico City. Dietary, anthropometric, family, and socioeconomic information was obtained from each participant. Dietary patterns were identified through cluster analysis. The association between dietary patterns with socioeconomic and home environmental factors was assessed by a multivariate multinomial logistic regression model. RESULTS: Three major dietary patterns were identified: diverse dietary pattern (D), high fat dietary pattern (HF), and high sugar dietary pattern (HS). 87% of the participants followed the HF or HS dietary patterns (36% & 51%, respectively). Mother's occupation and the child's screen time was associated with a significant likelihood of following a HF and HS dietary patterns. CONCLUSION: A high percentage of children and adolescents reported following a HS or HF dietary pattern, which in turn were associated with socioeconomic and home environmental factors. These results suggests priority groups for prevention and control actions.

One-year impact of a multicomponent, street-level design intervention in Mexico City on pedestrian crashes: a quasi-experimental study.

BACKGROUND: Mexico City implemented the Pasos Seguros programme to prevent pedestrian injuries and deaths at dangerous road intersections, which included street-level design changes, such as visible pedestrian crossings, sidewalk widening, refuge islands, lane reductions, pedestrian signals and adjustment of traffic light timing at these intersections. Few studies in low and middle-income countries (LMICs) have evaluated the effect of such interventions on pedestrian safety. AIM: Assess the effectiveness of the Pasos Seguros programme at reducing total, injury and fatal pedestrian-motor vehicle crashes. METHODS: Two-group quasi-experimental design. Monthly pedestrian crashes were obtained from the road incident database from Mexico City's Citizen Contact Center. The programme's effectiveness was evaluated by comparing 12 months preintervention to 12 months postintervention implementation using a negative binomial regression with random intercept with a difference-in-difference estimation. A qualitative comparative analysis was used to find the configuration of intersection characteristics and programme components associated with a decrease in pedestrian crashes. RESULTS: Total pedestrian crashes were reduced by 21% (RR 0.79; 95% CI 0.62 to 0.99) after implementation of Pasos Seguros programme. This reduction was observed for pedestrian injury crashes (RR 0.79; 95% CI 0.62 to 1.00) and for fatal crashes (RR 0.61; 95% CI 0.13 to 2.92) although not statistically significant for the latter. A decrease in pedestrian crashes was found at the most complex intersections where more of the programme components was implemented. CONCLUSION: The Pasos Seguros programme successfully decreased total and injury pedestrian crashes. Similar interventions may improve walking safety in other LMIC cities.

Individual and climate factors associated with acute respiratory infection in Colombian children.

The objective of this study was to examine the association between acute respiratory infection recall (ARI-recall) and individual and environmental factors such as climate, precipitation, and altitude above sea level in Colombian children. A secondary analysis of 11,483 Colombian children, whose mothers were interviewed in the 2010 National Demographic and Health Survey, was carried out. The outcome variable was the mother's or caregiver's ARI-recall. The independent variables were expressed at individual, cluster, and municipal levels. At the individual level, we considered health and individual characteristics of the children; at cluster level, we incorporated the altitude above sea level; and at the municipal level, we included precipitation and annual average climate. The association between ARI-recall and independent variables was assessed using a multilevel logistic regression model. ARI-recall was significantly associated with age (OR = 0.61; 95%CI: 0.48-0.79), belonging to an indigenous group (OR = 1.51; 95%CI: 1.16-1.96), and a medium or very poor wealth index (OR = 2.03; 95%CI: 1.25-3.30 and OR = 1.75; 95%CI: 1.08-2.84, respectively). We found interaction between acute child malnutrition and average annual precipitation. Children with acute malnutrition and from municipalities with high annual precipitation had significantly 3.6-fold increased risk of ARI-recall (OR = 3.6; 95%CI: 1.3-10.1). Individual conditions and precipitation are risk factors for ARI-recall in Colombian children. These results could be useful to understand ARI occurrence in children living in tropical countries with similar characteristics.

Generation and evaluation of an indicator of the health system's performance in maternal and reproductive health in Colombia: An ecological study.

OBJECTIVE: To generate and evaluate an indicator of the health system's performance in the area of maternal and reproductive health in Colombia. MATERIALS AND METHODS: An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the states were classified according to the indicator's score. A path analysis was used to evaluate the relationship between the indicator and social determinants, with the maternal mortality ratio as the response variable. RESULTS: The factor analysis indicates that only one principal factor exists, namely "coverage and utilization of maternal healthcare services" (eigenvalue 4.35). The indicator performed best in the states of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander (Q4). The poorest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. The indicator's behavior was found to have an association with the unsatisfied basic needs index and women's education (ß = -0.021; 95%CI -0031 to -0.01 and ß 0.554; 95%CI 0.39 to 0.72, respectively). According to the path analysis, an inverse relationship exists between the proposed indicator and the behavior of the maternal mortality ratio (ß = -49.34; 95%CI -77.7 to -20.9); performance was a mediating variable. DISCUSSION: The performance of the health system with respect to its management of access and coverage for maternal and reproductive health appears to function as a mediating variable between social determinants and maternal mortality in Colombia.

Exploratory wavelet analysis of dengue seasonal patterns in Colombia.

INTRODUCTION: Dengue has a seasonal behavior associated with climatic changes, vector cycles, circulating serotypes, and population dynamics. The wavelet analysis makes it possible to separate a very long time series into calendar time and periods. This is the first time this technique is used in an exploratory manner to model the behavior of dengue in Colombia.  OBJECTIVE: To explore the annual seasonal dengue patterns in Colombia and in its five most endemic municipalities for the period 2007 to 2012, and for roughly annual cycles between 1978 and 2013 at the national level.  MATERIALS AND METHODS: We made an exploratory wavelet analysis using data from all incident cases of dengue per epidemiological week for the period 2007 to 2012, and per year for 1978 to 2013. We used a first-order autoregressive model as the null hypothesis.  RESULTS: The effect of the 2010 epidemic was evident in both the national time series and the series for the five municipalities. Differences in interannual seasonal patterns were observed among municipalities. In addition, we identified roughly annual cycles of 2 to 5 years since 2004 at a national level.  CONCLUSIONS: Wavelet analysis is useful to study a long time series containing changing seasonal patterns, as is the case of dengue in Colombia, and to identify differences among regions. These patterns need to be explored at smaller aggregate levels, and their relationships with different predictive variables need to be investigated.

Maternal mortality in Colombia in 2011: a two level ecological study.

OBJECTIVE: Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia. METHODS: A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model. RESULTS: The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99). CONCLUSION: Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach.

[Tobacco control: an intersectorial experience in Tunja (Colombia)]. / Control del tabaco: una experiencia desde la intersectorialidad en Tunja (Colombia).

Tobacco control in Colombia is regulated by Law 1335 of 2009. The implementation and monitoring of the provisions of this law require strengthening of intersectorial work at the local level. This field note presents an intersectorial work experience that was carried out in the municipality of Tunja (Colombia) to improve tobacco control. The Respirarte Group was established. This group consists of an intersectorial team composed of 15 institutions. The Respirarte Group achieved the following political and community actions: signing of an agreement on tobacco control by government actors, expedition of a local decree to comply with Law 1335 in the municipality, provision of information and communication, and social mobilization and monitoring. This experience serves as a national and international reference and its lessons could be used in the approach to other public health problems.

Individual and climate factors associated with acute respiratory infection in Colombian children / Factores individuales y climáticos asociados a la infección respiratoria aguda en niños colombianos / Fatores individuais e climáticos associados à infecção respiratória aguda em crianças colombianas

The objective of this study was to examine the association between acute respiratory infection recall (ARI-recall) and individual and environmental factors such as climate, precipitation, and altitude above sea level in Colombian children. A secondary analysis of 11,483 Colombian children, whose mothers were interviewed in the 2010 National Demographic and Health Survey, was carried out. The outcome variable was the mother's or caregiver's ARI-recall. The independent variables were expressed at individual, cluster, and municipal levels. At the individual level, we considered health and individual characteristics of the children; at cluster level, we incorporated the altitude above sea level; and at the municipal level, we included precipitation and annual average climate. The association between ARI-recall and independent variables was assessed using a multilevel logistic regression model. ARI-recall was significantly associated with age (OR = 0.61; 95%CI: 0.48-0.79), belonging to an indigenous group (OR = 1.51; 95%CI: 1.16-1.96), and a medium or very poor wealth index (OR = 2.03; 95%CI: 1.25-3.30 and OR = 1.75; 95%CI: 1.08-2.84, respectively). We found interaction between acute child malnutrition and average annual precipitation. Children with acute malnutrition and from municipalities with high annual precipitation had significantly 3.6-fold increased risk of ARI-recall (OR = 3.6; 95%CI: 1.3-10.1). Individual conditions and precipitation are risk factors for ARI-recall in Colombian children. These results could be useful to understand ARI occurrence in children living in tropical countries with similar characteristics.

El objetivo del estudio fue examinar la asociación entre el historial de infección respiratoria aguda (IRA) y factores individuales y ambientales, tales como clima, precipitación y altitud por encima del nivel del mar en niños colombianos. Se realizó un análisis secundario de datos de 11.483 niños colombianos, cuyas madres fueron entrevistadas por la Encuesta Nacional de Demografía y Salud de 2010. La variable dependiente era el historial de IRA informado por la madre o cuidador(a). Las variables independientes se expresaron en el nivel individual, de clúster y municipal. En el nivel individual, consideramos las características individuales y de salud de los niños; en nivel de clúster, incorporamos la altitud sobre el nivel del mar y, en nivel municipal, incluimos la precipitación y el clima medio anual. La asociación entre el historial de IRA y las variables independientes se evaluaron con un modelo de regresión logística multinivel. El historial de IRA mostró una asociación significativa con la edad (OR = 0,61; IC95%: 0,48-0,79), pertenecer a un grupo indígena (OR = 1,51; IC95%: 1,16-1,96) y al estrato socioeconómico médio o muy bajo (OR = 2,03; IC95%: 1,25-3,30 y OR = 1,75; IC95%: 1,08-2,84, respectivamente). Identificamos una interacción entre la desnutrición infantil aguda y la precipitación anual promedio. Los niños con desnutrición aguda y aquellos de municipios con precipitaciones anuales altas mostraron un riesgo significativo 3,6 veces mayor de historial de IRA (OR = 3,6; IC95%: 1,3-10,1). Las condiciones individuales y la precipitación son factores de riesgo para el historial de IRA en niños colombianos. Los resultados pueden ser útiles para comprender la ocurrencia de IRA en niños que viven en países tropicales con características semejantes.

O estudo teve como objetivo examinar a associação entre história de infecção respiratória aguda (IRA) e fatores individuais e ambientais tais como clima, precipitação e altura acima do nível do mar em crianças colombianas. Foi realizada uma análise secundária dos dados de 11.483 crianças colombianas cujas mães foram entrevistadas pela Pesquisa Nacional de Demografia e Saúde de 2010. A variável dependente era história de IRA informada pela mãe ou cuidador(a). As variáveis independentes foram expressas em nível individual, de cluster e municipal. No nível individual, consideramos as características individuais e de saúde das crianças; em nível de cluster, incorporamos a altitude acima do nível do mar e em nível municipal, incluímos a precipitação e o clima médio anual. A associação entre história de IRA e variáveis independentes foi avaliada com um modelo de regressão logística multinível. A história de IRA mostrou associação significativa com idade (OR = 0,61; IC95%: 0,48-0,79), pertencer a grupo indígena (OR = 1,51; IC95%: 1,16-1,96) e estrato socioeconômico médio ou muito baixo (OR = 2,03; IC95%: 1,25-3,30 e OR = 1,75; IC95%: 1,08-2,84, respectivamente). Identificamos interação entre desnutrição infantil aguda e precipitação anual média. As crianças com desnutrição aguda e aquelas de municípios com precipitação anual alta mostraram um risco significativo 3,6 vezes maior de história de IRA (OR = 3,6; IC95%: 1,3-10,1). As condições individuais e a precipitação são fatores de risco para história de IRA em crianças colombianas. Os resultados podem ser úteis para compreender a ocorrência de IRA em crianças vivendo em países tropicais com características semelhantes.

Análisis exploratorio de ondículas de los patrones de estacionalidad del dengue en Colombia / Exploratory wavelet analysis of dengue seasonal patterns in Colombia

Introducción. El dengue tiene un comportamiento estacional asociado a los cambios climáticos, los ciclos del vector, los serotipos circulantes y las dinámicas poblacionales. El análisis de ondículas permite descomponer una serie de tiempo muy larga en sus componentes de tiempo calendario y periodo. Esta es la primera vez que se utiliza esta técnica para generar un modelo exploratorio del comportamiento del dengue en Colombia. Objetivo. Examinar los patrones de estacionalidad interanual del dengue en Colombia, en particular en los cinco municipios más endémicos, para el periodo 2007 a 2012, y de los ciclos entre años entre 1978 y 2013 a nivel nacional. Materiales y métodos. Se hizo un análisis exploratorio de ondículas con base en los datos de los casos incidentes de dengue reportados por semana epidemiológica en el periodo de 2007 a 2012, y por año, en el periodo de 1978 a 2013. Se utilizó un modelo autorregresivo de primer orden como hipótesis nula. Resultados. Fue evidente el efecto de la epidemia de 2010 sobre la serie de tiempo a nivel nacional y la de los cinco municipios. Se observaron diferencias en los patrones de estacionalidad interanual por municipio. Asimismo, a nivel nacional se hallaron ciclos de dos a cinco años desde el 2004. Conclusiones. El análisis de ondícula permite estudiar una serie de tiempo larga con patrones de estacionalidad variables, como en el caso del dengue en Colombia, e identificar diferencias por regiones. Es necesario explorar estos patrones en niveles de agregación inferiores y evaluar su relación con diversas variables predictoras.

Introduction: Dengue has a seasonal behavior associated with climatic changes, vector cycles, circulating serotypes, and population dynamics. The wavelet analysis makes it possible to separate a very long time series into calendar time and periods. This is the first time this technique is used in an exploratory manner to model the behavior of dengue in Colombia. Objective: To explore the annual seasonal dengue patterns in Colombia and in its five most endemic municipalities for the period 2007 to 2012, and for roughly annual cycles between 1978 and 2013 at the national level. Materials and methods: We made an exploratory wavelet analysis using data from all incident cases of dengue per epidemiological week for the period 2007 to 2012, and per year for 1978 to 2013. We used a first-order autoregressive model as the null hypothesis. Results: The effect of the 2010 epidemic was evident in both the national time series and the series for the five municipalities. Differences in interannual seasonal patterns were observed among municipalities. In addition, we identified roughly annual cycles of 2 to 5 years since 2004 at a national level. Conclusions: Wavelet analysis is useful to study a long time series containing changing seasonal patterns, as is the case of dengue in Colombia, and to identify differences among regions. These patterns need to be explored at smaller aggregate levels, and their relationships with different predictive variables need to be investigated.

Promoción de una alimentación saludable: experiencia en Tunja, colombia / Healthy food promotion: experience in Tunja, Colombia / Promoção duma alimentação saudável: experiência em Tunja, Colombia

Las enfermedades crónicas no transmisibles son una prioridad de salud pública, representan las principales causas de enfermedad y muerte en el mundo y en Tunja; se estima que el consumo diario de cinco porciones de fruta y/o verdura es un factor protector que puede contribuir a la disminución de este tipo de enfermedades, no obstante, en Tunja, en la población de 15 a 44 años de edad, este consumo es insuficiente. Objetivo: diseñar, implementar y evaluar una estrategia de intervención para incrementar la disponibilidad de verduras en una comunidad de Tunja. Metodología: estudio cualitativo en el que se aplicaron cinco principios de la investigación basada en comunidad. Tuvo dos componentes: educativo y agricultura urbana, que se desarrollaron en cuatro fases: inserción en la comunidad, diseño, implementación y evaluación. Resultados: se realizaron siete sesiones educativas de carácter participativo y se implementaron ocho huertas caseras y una huerta comunitaria, aspectos que permitieron reflejar la importancia del consumo de verduras en la alimentación diaria. Se logró empoderamiento comunitario, construcción de redes sociales y visualización del rol del profesional de enfermería en el campo comunitario. Discusión: este proyecto es un referente piloto a nivel local que contribuye a la efectividad de procesos educativos en la ciudad y en contextos similares en torno al tema de alimentación saludable. Conclusión: la estrategia de intervención permitió incrementar la disponibilidad de verduras, empoderar a la comunidad, crear redes sociales y visualizar al profesional de enfermería en el direccionamiento y liderazgo de acciones comunitarias tendientes a promocionar estilos de vida saludables.

Non-transmissible chronic diseases are a top priority as to public health, as they represent the main cause of disease and death worldwide, and specifically, in Tunja. Daily consumption of five servings of fruit and/or vegetables is estimated to be a protecting factor that may help decrease this kind of diseases, however, fruit and vegetable consumption in Tunja, in people aged 15 to 44 years old, proves to be insufficient. Purpose: design, implement, and assess an intervention strategy to increase the availability of vegetables in a village of Tunja. Methodology: qualitative study that applied the five research principles based on the community. It includes two components: educational and urban agriculture. Both components developed in four phases: insertion in the community, design, implemented and assessment. Results: Seven participatory educational sessions were performed and eight domestic gardens and one community orchard were sowed in order to grow fruits and vegetables. These aspects will allow for reflecting the importance of eating vegetables in the daily food consumption. As a result of the research: community members were empowered, new social networks were created and the nursing professionals were given more visibility within the community. Discussion: this project is a pilot benchmark at local level that contributes to booster effectiveness of educational processes in the city and also in similar context revolving around healthy food. Conclusion: an intervention strategy allowed to increase the availability of vegetables, empower the community, create social networks, and make the nursing professionals visible in guiding and leading community actions geared to promote healthier life-styles.

As doenças crónicas não transmissíveis são uma prioridade de saúde pública, e representam as principais causas de doença e morte no mundo e em Tunja; estima-se que o consumo diário de cinco porções de fruta e/ou verdura é um fator protetor que pode contribuir para a diminuição deste tipo de doenças, porém, em Tunja, dentro da população de 15 até 44 anos de idade, este consumo é insuficiente. Objetivo: desenhar, implementar e avaliar uma estraté-gia de intervenção para incrementar a disponibilidade de verduras numa comunidade de Tunja. Metodologia: estudo qualitativo em que foram aplicados os cinco princípios da pesquisa com base na comunidade. Incluidois componentes: educativo e agricultura urbana, que foram desenvolvidos em quatro fases: inserção na comunida-de, desenho, implementação e avaliação. Resultados: realizaram-se sete sessões educativas de tipo participativo e implementaram-se oito hortas caseiras e uma horta comunitária. Estes aspectos permitiram refetir a importância do consumo de verduras na alimentação diária. Conseguiu-se outorgar poder à comunidade, também a cons-trução de redes sociais e a visibilidade do papel do professional de enfermagem no campo comunitário. Discussão: esse projeto é um referente piloto ao nível local que contribui com a efetividade de processos educativos na cidade e em contextos semelhantes em torno ao tema da alimentação saudável. Conclusão: a estratégia de intervenção permitiu incrementar a disponibilidade de verduras, outorgar poder à comu-nidade, criar redes sociais e visibilizar o professional de enfer-magem a respeito do direcionamento e da liderança de ações comunitárias voltadas à promoção de estilos de vida saudáveis.

Smoking in the population from 15 to 44 years of age from the city of Tunja, Colombia / Tabaquismo en la población de 15 a 44 años de la ciudad de Tunja, Colombia

Objective. To describe tobacco use, the situation of control measures established in the MPOWER plan, and knowledge regarding smoking and Legislation 1335 of 2009 in individuals from 15 to 44 years of age from the city of Tunja in the department of Boyacá (Colombia). Methodology. Cross-sectional descriptive study carried out in 2010, with the participation of 461 individuals from 15 to 44 years of age from the urban area. A two-stage quota sampling was made. Information was gathered by using the Global Adult Tobacco Survey. Results. A total of 27% of the participants were smokers; the average age for the start of tobacco use was 16 years; 80% of those surveyed manifested annoyance with respect to tobacco smoke in the environment; 33% were exposed to second-hand smoke at the work place and 20% in their homes. Tobacco use was found in public places, as well as actions for promotion and publicity of tobacco products in grocery stores and communication media. Seventy nine percent of the smokers have tried to give up smoking and 24% of them have received information to this respect by a healthcare professional. Conclusion. Tobacco use in Tunja is a public health problem that requires reinforcing strategies to prevent this problem in the city.

Objetivo. Describir el consumo de tabaco, la situación de las medidas de control establecidas en el plan MPOWER y los conocimientos frente al tabaquismo y la Ley 1335 de 2009 en personas entre los 15 y 44 años de la ciudad de Tunja (Colombia). Metodología. Estudio descriptivo transversal realizado en 2010. Participaron 461 personas entre los 15 y 44 años del área urbana. Se hizo muestreo bietápico por cuotas. La información se recolectó haciendo uso de la Encuesta Global de Tabaquismo en adultos. Resultados. El 27% de los participantes era fumador; el promedio de edad de inicio de consumo de tabaco fue 16 años. El 80% de los encuestados manifestó molestia por el humo de tabaco en el ambiente. Expuestos al humo de tabaco ajeno en su lugar de trabajo 33%, y 20% en su hogar. Se halló consumo de tabaco en lugares públicos y acciones de promoción y publicidad de productos de tabaco en tiendas y medios de comunicación. El 79% de los fumadores ha tratado de abandonar el tabaco y el 24% de ellos ha recibido información al respecto por parte de un profesional de salud. Conclusión. El consumo de tabaco en Tunja es un problema de salud pública que requiere reforzar las estrategias de prevención.

Objetivo. Descrever o consumo de fumo, a situação das medidas de controle estabelecidas no plano MPOWER e os conhecimentos frente ao tabagismo e a Lei 1335 de 2009 em pessoas de 15 a 44 anos da cidade de Tunja (Colômbia). Metodologia. Estudo descritivo transversal realizado em 2010. Participaram 461 pessoas de 15 a 44 anos da área urbana. Fez-se amostragem bietápico por quotas. A informação se coletou fazendo uso da Enquete Global de Tabagismo em Adultos. Resultados. O 27% dos participantes eram fumantes; a média de idade de início de consumo de fumo foi 16 anos. O 80% dos interrogados manifestaram moléstia pela fumaça de fumo no ambiente. Estavam expostos à fumaça de fumo alheio em seu lugar de trabalho 33% e 20% em seu lar. Achou-se consumo de fumo em lugares públicos e ações de promoção e publicidade de produtos de fumo em lojas e meios de comunicação. O 79% dos fumantes trataram de abandonar o fumo e o 24% deles receberam informação ao respeito por parte de um profissional de saúde. Conclusão. O consumo de fumo em Tunja é um problema de saúde pública que requer reforçar as estratégias de prevenção desta problemática na cidade.

Qué ofrecen las tiendas escolares y qué consumen los estudiantes durante el descanso?: estudio en la ciudad de Tunja, 2009 / What do snack bars in schools offer and what do students eat during recess time in the schools?: study in the city of tunja, 2009 / ¿Que oferecem as tendas escolares e que consumem os estudantes durante o descanso?: é estudo na cidade de Tunja, 2009

Objetivo: caracterizar la disponibilidad de productos en la tienda escolar y el consumo de alimentos durante el descanso en Instituciones Educativas Públicas de Básica Primaria de la ciudad de Tunja, con el fin de formular recomendaciones que promuevan una alimentación saludable en la población escolar. Materiales y métodos: estudio descriptivo de corte transversal realizado en 12 tiendas escolares y 137 estudiantes de Instituciones Educativas Públicas de Básica Primaria de Tunja seleccionados por muestreo aleatorio estratificado y quienes cumplieron los criterios de inclusión. La información se recolectó a través de una ficha de chequeo y un formulario de reporte de alimentos consumidos durante el descanso elaborados teniendo en cuenta criterios comunes encontrados en investigaciones similares. Los resultados se analizaron univariada y bivariadamente. Resultados: el 100% de las tiendas escolares disponía productos empaquetados, dulces y refrescos; el 91,6%, jugos procesados; 58,3%, paletas y empanadas; y 50%, gaseosas. Las frutas o verduras no se ofrecían en ninguna de las tiendas estudiadas. El 81% de los escolares consumieron alimentos durante el descanso. Los alimentos que los estudiantes compraron con mayor frecuencia en la tienda escolar fueron: dulces (42,2%), productos empaquetados, paletas/helados en una proporción del 24,63% para cada producto. Conclusiones: las tiendas escolares disponen alimentos catalogados por otros autores como productos densos energéticamente y de bajo valor nutricional; los estudiantes consumen este tipo de alimentos durante el descanso escolar. Situación que requiere estrategias de promoción de la salud encaminadas a incorporar frutas o verduras en el entorno educativo e incentivar su consumo en los niños.

Objective: to characterize the availability of products in the school snack bars and students´ food consumption during recess in Public Elementary Schools in the city of Tunja, in order to generate recommendations to promote healthy food among the school population. Materials and methods: descriptive cross-cutting study carried out in 12 snack bars with 137 public elementary school students from Tunja selected through a random stratified sampling and who complied with the inclusion criteria. The information was collected through a checking form and a consumed food during recess report format which were designed considering the common criteria found in similar investigations. The results were analyzed in a mono and multi varied manner. Results: 100% of school snack bars offered packed food products, candies, cookies and soft drinks; 91.6% offered processed fruit juice, 58.3% offered popsicles and pasties and 50% of the snack bars offered sodas. Fruits or vegetables were not offered in any of the snack bars studied. 81% of school students consumed food during recess. The food that the students bought more frequently in the school snack bars were: candies (42.2%), packed products, opsicles/ice cream in a proportion of 24.63% for each product. Conclusions: the school snack bars offered food catalogued by the authors as energetically dense with low nutritional value. Students consume this type of food during the school recess. This situation requires health promotion strategies focused on the inclusion of fruits and vegetables in the school environment and the encouragement for students to consume such products.

Objetivo: caracterizar a disponibilidade de produtos na tenda escolar e o consumo de alimentos durante o descanso em instituições Educativas Públicas de Básica Primaria da cidade de Tunja, com o fim de formular recomendações que promovam uma alimentação saudável na povoação escolar. Materiais e Métodos: estudo descritivo de corte transversal realizado em 12 tendas escolares e 137 estudantes de Instituições Educativas Públicas de Básica Primaria de Tunja selecionados com amostras aleatórias estratificadas e quens cumpriram os critérios de inclusão. A informação se coletou a través duma ficha de xequeou e um formulário de reporte de alimentos consumidos durante o descanso elaborados tendo em conta critérios comuns encontrados em pesquisas similares. Os resultados se analisaram uni-variadamente e bivariadamente. Resultados: o 100% das tendas escolares disponha produtos empacotes, doces e refrescos; o 91,6% jogos processados; 58,3% gelados e bolos; e 50%, refrigerantes. As frutas ou verduras não se ofereciam em nenhuma das tendas estudadas. O 81% dos escolares consumiram alimentos durante o descanso. Os alimentos que os estudantes compraram com maior freqüência foram: doces (42,2%), produtos empacotados, gelados numa proporção do 24,63% para cada produto. Conclusões: As tendas escolares dispõem alimentos catalogados por outros autores como produtos densos energicamente e debaixo valor nutricional; os estudantes consomem este tipo de alimentos durante o descanso escolar. ituação que requere estratégias de promoção da saúde encaminhadas a incorporar frutas ou verduras no entrono educativo e incentivar seu consumo nas crianças.

Implementación de la estrategia escuela saludable: una alianza intersectorial / Implementação da estratégia escola saudável: uma aliança inter-setorial / Implementation of healthy school strategies: an intersector alliance

Objetivo. Evaluar la implementación de la estrategia Escuela Saludable en una Institución de Educación Primaria de la zona rural de Nuevo Colón (Boyacá) en Colombia. Metodología. Estudio de caso único con dos fases; una diagnóstica y una de intervención. En la fase diagnóstica se hizo un estudio descriptivo de corte transversal para determinar la situación de salud de los escolares y se complementó la situación encontrada con un autodiagnóstico comunitario. La fase de intervención se enmarcó en dos campos de acción: con los miembros de la comunidad educativa y desde una perspectiva intersectorial e interinstitucional. Resultados. Se identificaron problemas del medio ambiente relacionados con las condiciones locativas de la Institución, y situaciones desfavorables en los escolares tanto a nivel familiar como individual. Se buscaron alternativas de solución a la problemática encontrada, a través de la participación comunitaria, la educación en salud y la construcción de alianzas entre comunidad educativa, sector salud, educación y autoridades municipales. Conclusión. La estrategia Escuela Saludable contribuyó al mejoramiento de la calidad de vida y desarrollo humano de los escolares.

Objective. To evaluate the implementation of healthy school strategies in a primary school institution in the rural area of Nuevo Colon (Boyacá) in Colombia. Methodology. Unique case study with two stages, a diagnostic one and an intervention one. In the diagnostic stage a cross sectional descriptive study was performed to determine scholars health status, the situation found was supplemented with a community self diagnosis. The intervention stage was framed into two fields of action: with the educational community members and form the inter sector and inter institution perspective. Results. Environment problems related with Invest Educ Enferm 2010;28(3) / 429 the location of the institutions and unfavorable situations in the scholars, both at the familiar and individual level were identified. Alternative solutions to the problems searched through community participation, health education and building alliances between the educational community, health field, education and municipal authorities. Conclusion. Healthy school strategies contributed to the improvement of scholars’ quality of life and human development.

Objetivo. Avaliar a implementação da estratégia Escola Saudável numa Instituição de Educação Primária da zona rural de Novo Colón (Boyacá) em Colômbia. Metodologia. Estudo de caso único com duas fases; uma diagnóstica e uma de intervenção. Na fase diagnóstica se fez um estudo descritivo de corte transversal para determinar a situação de saúde dos escolares e se complementou a situação encontrada com um auto-diagnóstico comunitário. A fase de intervenção se emoldurou em dois campos de ação: com os membros da comunidade educativa e desde uma perspectiva inter-setorial e interinstitucional. Resultados. Identificaram-se problemas do médio ambiente relacionados com as condições locativas da Instituição, e situações desfavoráveis nos escolares tanto a nível familiar como individual. Procuraram-se alternativas de solução à problemática encontrada, através da participação comunitária, a educação em saúde e a construção de alianças entre comunidade educativa, setor saúde, educação e autoridades municipais. Conclusão. A estratégia Escola Saudável contribuiu ao melhoramento da qualidade de vida e desenvolvimento humano dos escolares.