Economic valuation of the ecosystem of the high Andean hydrographic basin tributary of the Chumbao River, through multicriteria analysis.

Environmental wealth is the main basis of the social, cultural and economic development of a country, but if there is an absence of the valuation of these natural resources, it can lead to a disproportionate usufruct that causes the deterioration of the ecosystem and even collateral effects of human health. This research aimed to know the total economic value of the ecosystem of the high Andean water basin tributary of the Chumbao River, located between 2000 to 4800 meters above sea level belonging to the province of Andahuaylas, Apurimac region in Perú. The valuation procedure consisted of using the analytical method of multicriteria valuation applying the concept of Total Economic Value, which involved direct and indirect uses related to environmental assets, in which a collective panel of people from different training disciplines (experts) participated, which were made up of researchers, engineers, public officials, farmers and ecologists who had extensive knowledge about the environmental asset. of the geographical area in reference; and once the paired comparison survey was done, the total economic value was quantified up to three amounts, so the respondents were formed into three statistically significant segments (SIG<0.05). The cluster (1): assigned a weighting that quantifies to an economic value of USS 4,359,179,489.46; followed by cluster (2): an intermediate value of USS 4,029,902,444.41 and cluster (3): assigned a lower value to USS 774,163,167.16. Thus, it follows that, on average, 51.78% equals value in use and 48.21% equals value in non-use, respectively. This value expressed as an interval reflects the environmental ethical positions of the groups and makes available as an indicator to government authorities and society in order to exercise actions of environmental sustainability high andean.

Chemical characteristics of wildfire ash across the globe and their environmental and socio-economic implications.

The mobilisation of potentially harmful chemical constituents in wildfire ash can be a major consequence of wildfires, posing widespread societal risks. Knowledge of wildfire ash chemical composition is crucial to anticipate and mitigate these risks. Here we present a comprehensive dataset on the chemical characteristics of a wide range of wildfire ashes (42 types and a total of 148 samples) from wildfires across the globe and examine their potential societal and environmental implications. An extensive review of studies analysing chemical composition in ash was also performed to complement and compare our ash dataset. Most ashes in our dataset had an alkaline reaction (mean pH 8.8, ranging between 6 and 11.2). Important constituents of wildfire ash were organic carbon (mean: 204 g kg-1), calcium, aluminium, and iron (mean: 47.9, 17.9 and 17.1 g kg-1). Mean nitrogen and phosphorus ranged between 1 and 25 g kg-1, and between 0.2 and 9.9 g kg-1, respectively. The largest concentrations of metals of concern for human and ecosystem health were observed for manganese (mean: 1488 mg kg-1; three ecosystems > 1000 mg kg-1), zinc (mean: 181 mg kg-1; two ecosystems > 500 mg kg-1) and lead (mean: 66.9 mg kg-1; two ecosystems > 200 mg kg-1). Burn severity and sampling timing were key factors influencing ash chemical characteristics like pH, carbon and nitrogen concentrations. The highest readily dissolvable fractions (as a % of ash dry weight) in water were observed for sodium (18 %) and magnesium (11.4 %). Although concentrations of elements of concern were very close to, or exceeded international contamination standards in some ashes, the actual effect of ash will depend on factors like ash loads and the dilution into environmental matrices such as water, soil and sediment. Our approach can serve as an initial methodological standardisation of wildfire ash sampling and chemical analysis protocols.

Efficient quantitative assessment of robot swarms: coverage and targeting Lévy strategies.

Biologically inspiredstrategieshave long been adapted to swarm robotic systems, including biased random walks, reaction to chemotactic cues and long-range coordination. In this paper we applyanalysis toolsdeveloped for modeling biological systems, such as continuum descriptions, to the efficient quantitative characterization of robot swarms. As an illustration, both Brownian and Lévy strategies with a characteristic long-range movement are discussed. As a result we obtain computationally fast methods for the optimization of robot movement laws to achieve a prescribed collective behavior. We show how to compute performance metrics like coverage and hitting times, and illustrate the accuracy and efficiency of our approach for area coverage and search problems. Comparisons between the continuum model and robotic simulations confirm the quantitative agreement and speed up by a factor of over 100 of our approach. Results confirm and quantify the advantage of Lévy strategies over Brownian motion for search and area coverage problems in swarm robotics.

Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic.

PURPOSE: The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS: As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS: Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.

Social gradients in dental attendance among older adults: Findings from the National Survey on Demographics and Health in Peru.

OBJECTIVE: To assess the presence of inequalities in attendance to dental services in relation to socio-economic position (SEP) in a national sample of older adults in Peru. BASIC RESEARCH DESIGN: A cross-sectional study using multivariate regression analysis of secondary data obtained from the National survey on demographics and family health in Peru (Encuesta Nacional en Demografía y Salud familiar, ENDES). PARTICIPANTS: 4749 ≥60-year-olds. MAIN OUTCOME MEASURE: Attendance at dental health services in the last 2 years. Independent variable: Wealth Index as a measure of SEP. Covariates: Sex, age, natural region of residence, place of residence and health insurance coverage. RESULTS: There was a social gradient for the association between attendance to dental health services and SEP, with older adults from the richest (fifth) quintile showing a 3.01 times higher probability of visiting dental services (95%CI 2.15-4.19), those in the fourth quintile PR=2.19 (95%CI 1.61-3.00), third quintile PR=2.00 (95%CI 1.49-2.69), and those in the second quintile PR=1.42 (95%CI 1.10-1.84), when compared to the poorest quintile after adjusting for sex, age, residence, natural region and health insurance coverage. CONCLUSIONS: There is a clear social gradient in dental attendance among older adults in Peru. This is important to provide further insights into current national programmes and relevant long-term policies.

Wave energy to power a desalination plant in the north of Gran Canaria Island: Wave resource, socioeconomic and environmental assessment.

The Canary Islands are recognized as an area of particular interest to exploit and to promote the use of renewable energies as a way to reduce its energy dependence on fossil fuels and ultimately reach energy self-sufficiency and sustainability. A common major problem in mid-latitude small and remote islands is the low annual precipitation rate and the associated freshwater scarcity, leading to the installation of desalination plants powered by oil. In this context, the assessment of wave energy potential along with socioeconomic and environmental factors in a selected area at the north side of Gran Canaria Island shows that wave power availability is adequate for its exploitation and there are no sources of potential conflicts that prevent the installation of wave energy converters. In particular, the harvesting of wave energy to power existing seawater desalination plants, fully based in the use of oil, is considered as a viable, appealing and advantageous alternative over the direct injection to the electric network.

Measuring the relationships between adverse childhood experiences and educational and employment success in England and Wales: findings from a retrospective study.

OBJECTIVES: Educational and employment outcomes are critical elements in determining the life course of individuals, yet through health and other mechanisms, those who suffer adverse childhood experiences (ACEs) may experience barriers to achieve in these domains. This study examines the association between ACEs and poor educational outcomes, before considering the impact of ACEs and education on employment in adulthood. STUDY DESIGN: Retrospective cross-sectional surveys were conducted in England and Wales using a random stratified sampling methodology. METHODS: During face-to-face household interviews (n = 2881), data were collected on demographic factors, ACEs, self-rated childhood affluence, the highest qualification level attained and the current employment status. RESULTS: While respondents with ≥4 ACEs were significantly more likely to have no formal qualifications (adjusted odds ratio [AOR] = 2.18; P < 0.001), among those who did achieve secondary level qualifications, the presence of ACEs did not further impact subsequent likelihood of going on to attain college or higher qualifications. However, results suggest a persisting independent impact of high (≥4) ACEs, which were found to be significantly associated with both current unemployment (AOR = 2.52, P < 0.001) and long-term sickness and disability (AOR = 3.94, P < 0.001). Modelled levels of not being in employment ranged from as little as 3% among those with 0 or 1 ACE and higher qualifications to 62% among those with no qualifications and ≥4 ACEs (adjusted for age, gender and childhood affluence effects). CONCLUSIONS: Compulsory education may play a pivotal role in mitigating the effects of adversity, supporting the case for approaches within schools that build resilience and tackle educational inequalities. However, adults with ACEs should not be overlooked and efforts should be considered to support them in achieving meaningful employment.

Mediterranean diet, diet quality, and bone mineral content in adolescents: the HELENA study.

Dietary scores, rather than individual nutrients, allow exploring associations between overall diet and bone health. The aim of the present study was to assess the associations between the Mediterranean Diet Score for Adolescents (MDS-A) and the Diet Quality Index for Adolescents (DQI-A) and bone mineral content (BMC) among Spanish adolescents. Our results do not support an association between dietary scores or indices and BMC in adolescents. INTRODUCTION: To assess the associations between the MDS-A and a DQI-A with the BMC measured with dual-energy X-ray absorptiometry. METHODS: The MDS-A and the DQI-A were calculated in 179 Spanish adolescents, based on two 24-h dietary recalls from the HELENA cross-sectional study. The associations between the diet scores and the BMC outcomes [total body less head (TBLH), femoral neck (FN), lumbar spine (LS), and hip] were analyzed using logistic regression models adjusting for several confounders. RESULTS: Four hundred ninety-two models were included and only fruits and nuts and cereal and roots were found to provide significant ORs with regard to BMC. The risk of having low BMC reduced by 32% (OR 0.684; CI 0.473-0.988) for FN when following the ideal MDS-A, but this association lost significance when adjusting for lean mass and physical activity. For every 1-point increase in the cereal and root and the fruit and nut components, the risk of having low FN diminished by 56% (OR 0.442; CI 0.216-0.901) and by 67% (OR 0.332; CI 0.146-0.755), respectively. CONCLUSION: An overall dietary score or index is not associated with BMC in our adolescent Spanish sample.

Incidence, Clinical Characteristics, and Management of Psoriasis Induced by Anti-TNF Therapy in Patients with Inflammatory Bowel Disease: A Nationwide Cohort Study.

BACKGROUND: Psoriasis induced by anti-tumor necrosis factor-α (TNF) therapy has been described as a paradoxical side effect. AIM: To determine the incidence, clinical characteristics, and management of psoriasis induced by anti-TNF therapy in a large nationwide cohort of inflammatory bowel disease patients. METHODS: Patients with inflammatory bowel disease were identified from the Spanish prospectively maintained Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales registry of Grupo Español de Trabajo en Enfermedad de Croh y Colitis Ulcerosa. Patients who developed psoriasis by anti-TNF drugs were the cases, whereas patients treated with anti-TNFs without psoriasis were controls. Cox regression analysis was performed to identify predictive factors. RESULTS: Anti-TNF-induced psoriasis was reported in 125 of 7415 patients treated with anti-TNFs (1.7%; 95% CI, 1.4-2). The incidence rate of psoriasis is 0.5% (95% CI, 0.4-0.6) per patient-year. In the multivariate analysis, the female sex (HR 1.9; 95% CI, 1.3-2.9) and being a smoker/former smoker (HR 2.1; 95% CI, 1.4-3.3) were associated with an increased risk of psoriasis. The age at start of anti-TNF therapy, type of inflammatory bowel disease, Montreal Classification, and first anti-TNF drug used were not associated with the risk of psoriasis. Topical steroids were the most frequent treatment (70%), achieving clinical response in 78% of patients. Patients switching to another anti-TNF agent resulted in 60% presenting recurrence of psoriasis. In 45 patients (37%), the anti-TNF therapy had to be definitely withdrawn. CONCLUSIONS: The incidence rate of psoriasis induced by anti-TNF therapy is higher in women and in smokers/former smokers. In most patients, skin lesions were controlled with topical steroids. More than half of patients switching to another anti-TNF agent had recurrence of psoriasis. In most patients, the anti-TNF therapy could be maintained.

Symbol Digit Modalities Test: Normative data for the Latin American Spanish speaking adult population.

OBJECTIVE: To generate normative data on the Symbol Digit Modalities Test (SDMT) across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD: The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the SDMT as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS: The final multiple linear regression models explained 29-56% of the variance in SDMT scores. Although there were gender differences on the SDMT in Mexico, Honduras, Paraguay, and Guatemala, none of the four countries had an effect size greater than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS: This is the first normative multicenter study conducted in Latin America to create norms for the SDMT; this study will have an impact on the future practice of neuropsychology throughout the global region.

Verbal fluency tests: Normative data for the Latin American Spanish speaking adult population.

OBJECTIVE: To generate normative data for the Verbal Fluency Tests across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD: The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the Verbal Fluency Test as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS: The final multiple linear regression models for the letter F explained 8-30% of the variance, 7-32% for letter A, 8-32% for the letter S, and 16-43% for the animal category in Verbal Fluency Test scores. Although t-tests showed significant differences between men and women on the Verbal Fluency Test, they did not have an effect size larger than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS: This is the first normative multicenter study conducted in Latin America aiming to create norms for the Verbal Fluency Test; this study will have important outcomes for the future of neuropsychology in the region.

Analysis of contributing factors associated to related patients safety incidents in Intensive Care Medicine.

OBJECTIVE: To explore contributing factors (CF) associated to related critical patients safety incidents. DESIGN: SYREC study pos hoc analysis. SETTING: A total of 79 Intensive Care Departments were involved. PATIENTS: The study sample consisted of 1.017 patients; 591 were affected by one or more incidents. MAIN VARIABLES: The CF were categorized according to a proposed model by the National Patient Safety Agency from United Kingdom that was modified. Type, class and severity of the incidents was analyzed. RESULTS: A total 2,965 CF were reported (1,729 were associated to near miss and 1,236 to adverse events). The CF group more frequently reported were related patients factors. Individual factors were reported more frequently in near miss and task related CF in adverse events. CF were reported in all classes of incidents. The majority of CF were reported in the incidents classified such as less serious, even thought CF patients factors were associated to serious incidents. Individual factors were considered like avoidable and patients factors as unavoidable. CONCLUSIONS: The CF group more frequently reported were patient factors and was associated to more severe and unavoidable incidents. By contrast, individual factors were associated to less severe and avoidable incidents. In general, CF most frequently reported were associated to near miss.

Audits in real time for safety in critical care: definition and pilot study.

UNLABELLED: Adverse events significantly impact upon mortality rates and healthcare costs. PURPOSE: To design a checklist of safety measures based on relevant scientific literature, apply random checklist measures to critically ill patients in real time (safety audits), and determine its utility and feasibility. METHODS: A list of safety measures based on scientific literature was drawn up by investigators. Subsequently, a group of selected experts evaluated these measures using the Delphi methodology. Audits were carried out on 14 days over a period of one month. Each day, 50% of the measures were randomly selected and measured in 50% of the randomized patients. Utility was assessed by measuring the changes in clinical performance after audits, using the variable improvement proportion related to audits. Feasibility was determined by the successful completion of auditing on each of the days on which audits were attempted. RESULTS: The final verified checklist comprised 37 measures distributed into 10 blocks. The improvement proportion related to audits was reported in 83.78% of the measures. This proportion was over 25% in the following measures: assessment of the alveolar pressure limit, checking of mechanical ventilation alarms, checking of monitor alarms, correct prescription of the daily treatment orders, daily evaluation of the need for catheters, enteral nutrition monitoring, assessment of semi-recumbent position, and checking that patient clinical information is properly organized in the clinical history. Feasibility: rounds were completed on the 14 proposed days. CONCLUSIONS: Audits in real time are a useful and feasible tool for modifying clinical actions and minimizing errors.

[Risk factors for the deterioration of quality of life in critical trauma patients. Assessment at 6 and 12 months after discharge from the intensive care unit]. / Factores de riesgo de deterioro de calidad de vida en pacientes traumáticos críticos. Valoración a los 6 y 12 meses del alta de la unidad de cuidados intensivos.

OBJECTIVE: To evaluate factors influencing the deterioration of health-related quality of life (HRQoL) in trauma patients admitted to an ICU. DESIGN: A prospective observational study was carried out. SETTING: The combined medical/surgical ICU in a university secondary hospital with 24-hour neurosurgery service. PATIENTS: Trauma patients admitted to the ICU during a two-year period. HRQoL assessment prior to admission to the ICU, and at 6 and 12 months after discharge. MAIN VARIABLES: Demographic variables, type and severity of injury (AIS), severity (APACHE II, ISS, TRISS), length of stay, procedures, mortality and HRQoL according to the SF-36 and EQ-5D. RESULTS: We completed the monitoring of 110 patients that showed significant impairment of their HRQoL in all the dimensions assessed. According to the SF-36, physical role was more deteriorated at 12 months, but the mental component decreased more than the physical component after 6 months. The VAS scale of the EQ-5D decreased to 55 at 6 months (19) and increased to 66 at 12 months (17). In the multiple logistic regression analysis, the variables associated with poorer HRQoL were age > 45 years, TRISS > 10, previous porer quality of life, and serious injuries in the extremities. CONCLUSIONS: Patients showed marked deterioration of their HRQoL at 6 months, followed by overall improvement at 12 months, though without reaching their previous state. The factors that determine poorer quality of life include age, severity, previous HRQoL, and severe injuries in the extremities.

Socioeconomic status influences physical fitness in European adolescents independently of body fat and physical activity: the HELENA study.

INTRODUCTION: The influence of socioeconomic status on health-related fitness is not clear. AIM: To examine the influence of socioeconomic status on health-related fitness in adolescents. METHODS: A total of 3,259 adolescents (15.0 +/- 1.3 y) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) participated in the study. Socioeconomic status was assessed by the family affluence scale (FAS). Speed-agility, muscular strength and cardiorespiratory fitness were assessed. Covariates included total body fat, physical activity and pubertal status. RESULTS: Adolescents with high FAS had significantly higher fitness levels than their peers of lower FAS categories except for speed-agility and handgrip in boys. Overall, the associations observed presented a medium to large effect size. CONCLUSION: These results suggest that socioeconomic status is positively associated with physical fitness in European adolescents independently of total body fat and habitual physical activity.

Is liver transaminases assessment an appropriate tool for the screening of non-alcoholic fatty liver disease in at risk obese children and adolescents?

Pediatric obesity has increased dramatically all over the world and nonalcoholic fatty liver disease (NAFLD) is one of the most frequent complications associated with excess adiposity. NAFLD causes serum transaminase elevation and liver disease, which could end up in fibrosis, cirrhosis and eventually hepatocellular carcinoma. NAFLD seems to be associated with the metabolic complications of obesity, mainly insulin resistance. The aim of the present article is to review the role of serum liver enzyme assessment as a suitable non invasive predictor of NAFLD in children. Although serum liver enzyme elevation does not accurately measure liver damage, it may be a valuable and non invasive test to screen NAFLD in children and adolescents and a marker to control NAFLD evolution. To detect NAFLD in obese children and adolescents, transaminases serum concentrations should be routinely determined in these patients. In this sense, it seems necessary to obtain transaminase reference standards for children and adolescents.

Development of a short olfactory test based on the Connecticut Test (CCCRC).

OBJECTIVE: To create a short olfactory test, Connecticut Smell Test (CST), based on the CCCRC (Connecticut Chemosensor and Clinical Research Center). DESIGN: A prospective patient-based study. SETTINGS: Smell and Taste Outpatient Clinic at the Fundación Hospital Alcorcón, Madrid, Spain. MATERIAL AND METHODS: We compared a short test based on the CCCRC with the Pocket Smell Test (PST) based on the University of Pennsylvania Smell Identification Test) UPSIT in 40 patients with nasal polyposis, in order to determine the specificity, sensitivity, positive predictive and negative predictive values. The validity index was 95% with an accuracy rate of 10%. We determined unit cost, the time required to perform the test in the outpatient office and the difficulty to perform the test. RESULTS: The sensibility was 93.3% and the specificity was 76% with a positive predictive value of 70% and a negative predictive value of 95%. The unitary cost of CST was euro0.65 when it is performed by a doctor. The unitary cost of PST is euro1.76. Our short test took 34 seconds to perform. More than 96% of the patients thought the test was easy to do. CONCLUSION: Our test is a valid, easy and quick test to be used in patients with nasal polyposis.

Harmonization process and reliability assessment of anthropometric measurements in a multicenter study in adolescents.

OBJECTIVE: To describe the standardization process and reliability of anthropometric and bioelectrical impedance analysis (BIA) measurements. We examined both intra- and interobserver errors for skinfolds, circumferences and BIA. METHODS: For the intraobserver error assessment, first of all, 202 adolescents in the pilot study (110 boys, 92 girls, aged 13.64+/-0.78 years) were assessed. For the second intraobserver and interobserver assessments, 10 adolescents were studied (5 boys and 5 girls). RESULTS: The pilot study's intraobserver technical errors of measurement (TEMs) were between 0.12 and 2.9 mm for skinfold thicknesses, and between 0.13 and 1.75 cm for circumferences. Intraobserver reliability for skinfold thicknesses was greater than 69.44% and beyond 78.43% for circumferences. The final workshop's intraobserver TEMs for skinfold thicknesses and circumferences were smaller than 1; for BIA resistance TEMs were smaller than 0.1 Omega and for reactance they were smaller than 0.2 Omega. Intraobserver reliability values were greater than 95, 97, 99 and 97% for skinfold thicknesses, circumferences, BIA resistance and reactance, respectively. Interobserver TEMs for skinfold thicknesses and circumferences ranged from 1 to 2 mm; for BIA they were 1.16 and 1.26 Omega for resistance and reactance, respectively. Interobserver reliability for skinfold thicknesses and circumferences were greater than 90%, and for BIA resistance and reactance they were greater than 90%. CONCLUSIONS: After the results of the pilot study, it was necessary to optimize the quality of the anthropometric measurements before the final survey. Significant improvements were observed in the intraobserver reliabilities for all measurements, with interobserver reliabilities being higher than 90% for most of the measurements.The Healthy Lifestyle in Europe by Nutrition in Adolescence Study aims to describe total body fat percentage and anthropometric indices of body fat distribution in European adolescents.

La violencia en la palabra: narraciones de madres atrapadas en sus redes sociales* / Violence in the Word: Narratives of Mothers Trapped in Their Social Networks

Objetivo: Realizar un estudio descriptivo y analítico sobre los imaginarios de mujeres embarazadas en condiciones de precariedad y violencia, acerca de su percepción del embarazo y de sus redes intrafamiliares y extrafamiliares, por medio de sus narrativas. Método: Se aplicó una encuesta a 350 mujeres gestantes del programa Familia Gestante-Bebé Sano, del Departamento Administrativo de Bienestar Social de la Localidad de Usaquén, con seguimiento de un año (seis meses de gestación y seis meses de crianza del niño), realizando un análisis a profundidad de la narrativa en 50 madres entrevistadas. Resultados: Las mujeres entrevistadas pertenecen, en su mayoría, a familias extensas, jerarquizadas, rígidas en su dinámica, con prácticas monótonas, cuyos valores son impuestos por el grupo familiar (padres o pareja) y relaciones ambiguas con las instituciones. De ellas, 44% no venían planifi cando y 52% no lo hacen luego del parto; 92% no son propietarias y la mayoría manejan relaciones de dependencia. Más de la mitad suspendieron su escolaridad al quedar embarazadas y tres cuartas partes no trabajan. Conclusiones: La población evaluada requiere mayor apoyo para el fomento de su autonomía en la toma de decisiones en temas como sexualidad, escolaridad, tenencia de propiedad, planifi cación y, en general, un mayor conocimiento y ejercicio de sus derechos ciudadanos.

Objective: To carry out a descriptive and analytical study on the imaginaries of pregnant women in precarious and violent conditions, concerning their perception on pregnancy, and their intra and extrafamily networks, basing this study on their usual speech. Methodology: Survey applied to 350 pregnant women from the “Gestating familyhealthy baby” Program of the Administrative Department of Social Welfare at Usaquén (Bogotá), with a one-year monitoring period (six month during pregnancy and six month during the nursing stage), based on the detailed speech analysis of the interviews with 50 women. Results: Most of the interviewed women belong to extensive, hierarchical families, with rigid dynamics and monotonous practices; their values are imposed by the family group (parents or couple) and they have ambiguous relationship with institutions. 44% of them did not use any birth control method, and 52% would not use it after the labor. 92% of the women are not house owners, and the majority of them manage relationships of dependence. More than 50% suspended their studies due to pregnancy and 75% do not work. Conclusions: The evaluated population requires greater support in order to promote its autonomy in making decisions about topics like sexuality, education, house ownership, birth control, and, in general, exercising their civil rights.