A Great Challenge: Preserve or Improve the Classification of the Journal Investigación y Educación en Enfermería

The first issue of the IEE Journal was published in September 1983 and it was the beginning of a permanent growth process for the dissemination of knowledge in Nursing, product of research, theoretical reflection, and exchange of care experiences. It was regulated by Agreement 027 of 02 August of 2005 by the Academic Council of the Faculty of Nursing at Universidad de Antioquia, which defines it as "the dissemination body, through which technical and scientific knowledge is disseminated referring to health and disease and to processes related with such, to the practice of Nursing and of other health and related disciplines. It also constitutes a channel to exchange knowledge and experiences with national and foreign disciplines of the social and health sciences".

Implementation of the clinical practice guideline for individuals with amputations in Colombia: a qualitative study on perceived barriers and facilitators.

BACKGROUND: The issue of lower extremity amputation has been in the Colombian political agenda for its relationship with the armed conflict and antipersonnel mines. In 2015 the Colombian Ministry of Health published a national clinical practice guideline (CPG) for amputee patients. However, there is a need to design implementation strategies that target end-users and the context in which the CPG will be used. This study aims to identify users' perceptions about the barriers and facilitators for implementing the guideline for the care of amputee patients in a middle-income country such as Colombia. METHODS: Semi-structured interviews were conducted with 38 users, including patients, health workers, and administrative staff of institutions of the health system in Colombia. Individuals were purposively selected to ensure different perspectives, allowing a balance of individual positions. RESULTS: According to participants' perceptions, barriers to implementation are classified as individual barriers (characteristics of the amputee patient and professionals), health system barriers (resource availability, timely care, information systems, service costs, and regulatory changes), and barriers related to clinical practice guidelines (utility, methodological rigour, implementation flexibility, and characteristics of the group developing the guidelines). CONCLUSIONS: Our study advances knowledge on the perceived individual and health system barriers and facilitators for the implementation of the CPG for amputee patients in Colombia. Importantly, the governance, financial, and service delivery arrangements of the Colombian health system are determining factors in implementing CPGs. For example, the financial arrangements between the insurance companies and the health care provider institutions were identified as barriers for the implementation of recommendations related to the continuity and opportunity of care of patients with amputations. The design of implementation strategies that successfully address the individual behaviours and the contextual health systems arrangements may significantly impact the health care process for amputee patients in Colombia.

Sobrepeso, obesidad y factores de riesgo: un modelo explicativo para estudiantes de Nutrición y Dietética de una universidad pública de Medellín, Colombia / Overweight, Obesity and Risk Factors: An Explanatory Model for Nutrition and Dietetics Students from a Public University in Medellín, Colombia

Resumen Antecedentes: el sobrepeso y la obesidad son considerados una epidemia. Es importante indagar sobre estas condiciones en estudiantes de Nutrición y Dietética, pues en su desempeño profesional serán actores relevantes en la prevención e intervención de esta problemática. Objetivo: identificar la prevalencia de sobrepeso y obesidad y sus factores asociados en estudiantes de Nutrición y Dietética de una universidad pública de Medellín, Colombia. Materiales y métodos: estudio descriptivo trans versal realizado por muestreo aleatorio estratificado con 201 estudiantes. Se aplicó un cuestionario estructurado autodiligenciado que incluyó variables para identificar factores de riesgo relacionados con características sociodemográficas, antecedentes familiares y conductas saludables; así como síntomas de ansiedad y depresión. Para estimar la prevalencia de sobrepeso y obesidad, se calculó el IMC. Resultados: la prevalencia de exceso de peso fue de 17,9 % (15,9 % sobrepeso y 2,0 % obesidad). Existe asociación estadísticamente significativa entre exceso de peso, las variables sexo (OR=4,6) y el antecedente familiar de hipertensión (OR=3,2). La conducta no saludable más frecuente fue la no realización de actividad física (53,7 %). De los estudiantes encuestados, el 64,7 % refirió síntomas presuntivos de ansiedad y el 57,2 % de depresión; sin embargo, no se encontró asociación estadísticamente significativa entre estas variables y el exceso de peso. Conclusiones: la prevalencia de exceso de peso en el grupo estudiado es inferior a la de otros estudiantes universitarios. El exceso de peso se asocia, según el modelo predictivo, con ser mujer, tener antecedentes familiares de hipertensión y la conducta de continuar comiendo aun cuando se está satisfecho; además, se encuentra un alto porcentaje de estudiantes con síntomas presuntivos de depresión y ansiedad.

Abstract Background: Overweight and obesity are considered an epidemic. It's important to investigate the factors surrounding these conditions in nutrition and dietetics students; given that in the discourse of their studies and careers these risk factors and conditions will be relevant in the prevention and control of this epidemic. Objective: Identify the prevalence of overweight and obesity and related factors in nutrition and dietetics students in a public university in Medellin, Colombia. Materials and Methods: Descriptive cross-sectional study carried out by stratified random sampling in 201 students. A self-report structured questionnaire was applied that included variables to identify risk factors related to sociodemographic characteristics, family history and health behaviors, as well as symptoms of anxiety and depression. To estimate the prevalences of overweight and obesity, BMI was used. Results: The combined prevalence of overweight and obesity was 17.9% (15.9% overweight and 2.0% obesity). A statistically significant association was found between excess weight and gender (OR=4.6) and family history of hypertension (OR=3.2). The most frequent unhealthy behavior identified was not participating in physical activity (53.7%). Of participant students, 64.7% referred to symptoms of anxiety and 57.2% to symptoms of depression; however, it must be noted that no statistical significance was found between these variables and excess weight. Conclusions: The prevalence of excess weight in the group studied is less than in other university students. Excess weight is associated with female gender, family history of hypertension, and the habit of continuing to eat even once one feels full. Additionally, it was found that a high percentage of students identify with symptoms indicative of anxiety and depression.

Sinergias y continuidades en las políticas públicas relacionadas con enfermedades cardio-cerebro-vasculares. Medellín, Colombia, 2000-2013 / Synergies and Continuities in Public Policies Related to Cardio-cerebrovascular Diseases. Medellín, Colombia, 2000-2013 / Sinergias e continuidades nas políticas públicas relacionadas com doenças cárdio-cerebro-vasculares. Medellín, Colômbia, 2000-2013

Resumen Objetivo: analizar sinergias y continuidades entre acuerdos municipales relacionados con enfermedades cardio-cerebro-vasculares en Medellín, Colombia entre 2000-2013, como un proceso que trasciende la formalización del discurso. Metodología: estudio cualitativo, se revisaron 57 acuerdos y se realizaron doce entrevistas semiestructuradas a actores clave. Hallazgos: la formulación de algunos acuerdos partió de orientaciones externas o del diagnóstico local, lo que muestra continuidad y coherencia en la secuencia del ciclo de la política. Con respecto a la sinergia, proponen acciones para impactar positivamente las decisiones tomadas: construcción de alianzas y redes en los distintos niveles; desarrollo de estrategias de información, educación y comunicación; estímulo a la participación ciudadana y mejoramiento del acceso a la atención en salud. Conclusión: el análisis implicó considerar relaciones entre políticas que contemplen acciones que incidan en las enfermedades cardio-cerebro-vasculares y posibiliten su continuidad por las condiciones presupuestales, administrativas y de ejecución.

Abstract Objective: to analyze synergies and continuities between municipal agreements related to cardio-cerebrovascular diseases in Medellín, Colombia between the years 2000-2013, as a process that goes beyond the formalization of discourse. Methodology: qualitative study, 57 agreements were reviewed and twelve semi-structured interviews were conducted with key stakeholders. Findings: the formulation of some agreements was based on external orientations or local diagnosis, which shows continuity and coherence in the sequence of the policy cycle. Regarding synergy, they propose actions to positively impact the decisions taken: building alliances and networks at different levels; development of information, education, and communication strategies; fostering citizen participation, and improving access to health care. Conclusion: the analysis involved considering relationships between policies that contemplate actions that have an effect on cardio-cerebrovascular diseases and enable their continuity given the budgetary, administrative, and implementation conditions.

Resumo Objetivo: analisar sinergias e continuidades entre acordos municipais relacionados com doenças cárdio-cerebro-vasculares em Medellín, Colômbia entre 2000-2013, como processo que transcende a formalização do discurso. Metodologia: estudo qualitativo, 57 acordos foram revistos e realizaram-se doze entrevistas semiestruturadas a atores chave. Achados: a formulação de alguns acordos partiu de orientações externas ou do diagnóstico local, o que mostra continuidade e coerência na sequencia do ciclo da política. No que diz respeito da sinergia, propõem ações para impactar positivamente as decisões tomadas: construção de parcerias e redes nos diferentes níveis; desenvolvimento de estratégias de informação, ensino e comunicação; estímulo à participação cidadã e melhoramento do acesso à atenção em saúde. Conclusão: a análise envolveu considerar relacionamentos entre políticas contemplando ações que incidirem nas doenças cárdio-cerebro-vasculares e possibilitarem a sua continuidade pelas condições orçamentarias, administrativas e de execução.

Sobrepeso y obesidad: prevalencia y factores de riesgo asociados en estudiantes de Enfermería en una universidad pública de Medellín, Colombia / Sobrepeso e obesidade: prevalência e fatores de risco associados em estudantes de Enfermagem numa universidade pública de Medellín, Colômbia / Overweight and Obesity Conditions: Prevalence and Associated Risk Factors in Nursing Students in a Public University in Medellín, Colombia

Objective. This work sought to identify the prevalence of overweight and obesity conditions and the associated factors in nursing students in a public university in Medellín, Colombia. Methodology. This was a descriptive cross-sectional study conducted in 2015. The study selected 171 participants through stratified random sampling. A structured questionnaire was applied and weight and height were taken to calculate the body mass index (BMI). Results. The prevalence of overweight condition was 25.1% and obesity at 7.6%. Statistically significant association exists with family background of overweight or obesity conditions (OR = 6.65) and the perception of unhealthy feeding (OR = 3.01). No association was found with cases suggesting anxiety and depression and physical activity. Conclusion. A high prevalence was found of overweight and obesity conditions in the population studied, which is why it is recommended to develop self-care programs in university populations, principally in Nursing, given that as future professionals they will be co-responsible for health promotion in individuals and collectives. (AU)

Objetivo. Identificar prevalencia de sobrepeso y de obesidad y los factores asociados en estudiantes de Enfermería en una universidad pública de Medellín, Colombia. Metodología. Estudio descriptivo transversal realizado en 2015. Se seleccionaron 171 participantes por muestreo aleatorio estratificado. Se aplicó un cuestionario estructurado y se tomó peso y talla para calcular Índice de Masa Corporal (IMC). Resultados. La prevalencia de sobrepeso fue de 25.1% y de obesidad 7.6%. Existe asociación estadísticamente significativa con antecedentes familiares de sobrepeso u obesidad (OR=6.65) y la percepción de alimentación no saludable (OR=3.01). No se encontró asociación con casos sugestivos de ansiedad y depresión y actividad física. Conclusión. Se encuentra una alta prevalencia de sobrepeso y obesidad en la población estudiada por lo que se recomienda desarrollar programas de autocuidado en población universitaria, principalmente en Enfermería, pues como futuros profesionales serán corresponsables de la promoción de la salud en individuos y colectivos. (AU)

Objetivo. Identificar prevalência de sobrepeso e de obesidade e os fatores associados em estudantes de Enfermagem numa universidade pública de Medellín, Colômbia. Metodologia. Estudo descritivo transversal realizado em 2015. Se selecionaram 171 participantes por amostragem aleatória estratificado. Se aplicou um questionário estruturado e se tomou peso e tamanho para calcular Índice de Massa Corporal (IMC). Resultados. A prevalência de sobrepeso foi de 25.1% e de obesidade 7.6%. Existe associação estatisticamente significativa com antecedentes familiares de sobrepeso ou obesidade (OR=6.65) e a percepção de alimentação não saudável (OR=3.01). Não se encontrou associação com casos sugestivos de ansiedade e depressão e atividade física. Conclusão. Se encontra uma alta prevalência de sobrepeso e obesidade na população estudada pelo qual se recomenda desenvolver programas de autocuidado na população universitária, principalmente em Enfermagem, pois como futuros profissionais serão correspondentes da promoção da saúde nos indivíduos e coletivos. (AU)

Overweight and Obesity Conditions: Prevalence and Associated Risk Factors in Nursing Students in a Public University in Medellín, Colombia.

OBJECTIVES: This work sought to identify the prevalence of overweight and obesity conditions and the associated factors in nursing students in a public university in Medellín, Colombia. METHODS: This was a descriptive cross-sectional study conducted in 2015. The study selected 171 participants through stratified random sampling. A structured questionnaire was applied and weight and height were taken to calculate the body mass index (BMI). RESULTS: The prevalence of overweight condition was 25.1% and obesity at 7.6%. Statistically significant association exists with family background of overweight or obesity conditions (OR = 6.65) and the perception of unhealthy feeding (OR = 3.01). No association was found with cases suggesting anxiety and depression and physical activity. CONCLUSIONS: A high prevalence was found of overweight and obesity conditions in the population studied, which is why it is recommended to develop self-care programs in university populations, principally in Nursing, given that as future professionals they will be co-responsible for health promotion in individuals and collectives.

Ansiedad, depresión y actividad física asociados a sobrepeso/obesidad en estudiantes de dos universidades mexicanas / Anxiety, depression and physical activity associated with overweight/obesity in students from two mexican universities / Ansiedade, depressão e atividade física associada ao excesso peso/obesidade em estudantes de duas universidades mexicanas

OBJETIVO: Determinar la asociación entre los trastornos afectivos (ansiedad, depresión), la actividad física y la prevalencia combinada de sobrepeso/obesidad en un grupo de estudiantes universitarios. MATERIALES Y MÉTODOS: Estudio descriptivo transversal realizado de mayo de 2013 a noviembre de 2014 en una muestra aleatoria de 450 estudiantes de enfermería y nutrición de dos universidades mexicanas. Se aplicó un cuestionario estructurado sobre actividad física y síntomas presuntivos de ansiedad y depresión, se midieron peso, talla y se calculó el índice de masa corporal (IMC). Los datos obtenidos se procesaron y analizaron en el software estadístico SPSS. RESULTADOS: La prevalencia combinada de sobrepeso/obesidad estimada según el IMC fue 32,4% en el total de la población de estudio; mayor en la Universidad Autónoma de Yucatán (UADY, 41%) que en la Universidad Autónoma de San Luis Potosí (UASLP, 27,5%), la diferencia entre universidades es estadísticamente significativa (p<0,05) la prevalencia es mayor en hombres (38,5%) que en mujeres (30,5%). Las variables que indagan sobre alteraciones en el apetito según el estado emocional advierten asociación estadísticamente significativa (p<0,05) entre sobrepeso/obesidad y aumento del apetito ante el estrés, ansiedad y tristeza. No existe suficiente evidencia estadística en los datos para establecer asociación entre sobrepeso-obesidad y la realización de actividad física, ni se encontraron diferencias en características de la actividad física entre universidades. CONCLUSIÓN: Se evidencian síntomas de ansiedad y depresión en estudiantes universitarios del área de salud, los cuales, asociados a una ingesta alimentaria excesiva y una actividad física leve predisponen al sobrepeso y la obesidad

OBJECTIVE: To decide the association between affective disorders (anxiety, depression), physical activity and combined prevalence of overweight/obesity in a group of university students. MATERIAL AND METHODS: Cross-sectional descriptive study conducted from May 2013 to November 2014 in a random sample of 450 nursing and nutrition students from two Mexican universities. A structured questionnaire on physical activity and presumptive symptoms of anxiety and depression was applied, weight and height were measured, and body mass index (BMI) was calculated. The data obtained was processed using the SPSS statistical software. RESULTS: The combined prevalence of overweight-obesity estimated by BMI was 32.4% in the total study population; it was higher in the Universidad Autónoma de Yucatán (UADY) (41%) than in the Universidad Autónoma San Luis Potosí (UASLP) (27.5%). The difference between universities is statistically significant (p<0.05), prevalence is higher in men (38.5%) than in women (30.5%). Variables that investigate alterations in appetite according to the emotional state show statistically significant association (p<0.05) between overweight-obesity and increased appetite for stress, anxiety and sadness. There is insufficient statistical evidence in the data to establish an association between overweight-obesity and physical activity and differences in physical activity characteristics between universities were not found. CONCLUSION: Symptoms of anxiety and depression in university students in the health area are evident, which, associated with excessive food intake and mild physical activity, lead to overweight and obesity

OBJECTIVO: Determinar a associação entre transtornos afetivos (ansiedade, depressão), atividade física e prevalência combinada de sobrepeso/obesidade em um grupo de estudantes universitários em duas universidades no México. MATERIAIS E MÉTODOS: De maio de 2013 a novembro de 2014, um estudo descritivo transversal foi realizado em uma amostra aleatória de 450 estudantes de enfermagem e nutrição em dois universidades mexicanas. Foi aplicado um questionário estruturado de atividade física e sintomas presuntivos de ansiedade e depressão, foram medidos peso, altura e índice de massa corporal (IMC) foi calculado. Os dados obtidos foram processados no software estatístico SPSS. RESULTADOS: A prevalência combinada de excesso de peso a obesidade é estimada pelo IMC de 32,4% na população total do estudo; maior na Universidade Autônoma de Yucatán (UADY) (41%) do que na Universidade Autônoma de San Luis Potosí (UASLP) (27,5%), a diferença entre universidades é estatisticamente significativa (p<0.05). A prevalência é maior em homens (38,5%) do que mulheres (30,5%). As variáveis que investigam alterações no apetite como o estado emocional alertar associação estatisticamente significativa (p<0,05) entre o excesso de peso à obesidade e aumento do apetite ao estresse, ansiedade e tristeza. Não há evidências estatísticas suficientes nos dados para estabelecer associação entre o excesso de peso à obesidade e atividade física, não há diferenças nas características da atividade física entre universidades. CONCLUSÃO: Se mostram sintomas de ansiedade e depressão em estudantes universitários da área de saúde, que, associada à ingestão excessiva de alimentos e atividade física uma ligeira vantagem ao sobrepeso e à obesidade

[Marking bourdaries as a strategy of social control: the case of homicidal violence in Medellin, Colombia]. / Delimitación de fronteras como estrategia de control social: el caso de la violencia homicida en Medellín, Colombia.

As part of a research study undertaken in the period 2003-2011 to understand situations of homicidal violence based in perceptions regarding the act of violence and the surrounding context, we reflect on the meaning of "invisible bourdaries" in the neighborhoods of Medellin (Colombia). Using a qualitative approach that combines documentary sources and interviews, the experiences of 8 participants are analyzed. In the primary results we can see how control over neighborhoods is exercised by different actors through bourdaries not visible to ordinary people. Nevertheless, around these lines people are recruited and controlled and strategies to illegally generate economic resources and to regulate the cultural and social activities of inhabitants are consolidated, thus affecting the social dynamics and imaginary of the neighborhood. In this way, the territories, friendships, and affects of young victims ­ who are not linked to illegal groups and/or do not have "information" ­ and of defenseless older adults are controlled.

Delimitación de fronteras como estrategia de control social: el caso de la violencia homicida en Medellín, Colombia / Marking bourdaries as a strategy of social control: the case of homicidal violence in Medellin, Colombia

En el marco de un estudio realizado entre 2003 y 2011 para comprender escenarios de violencia homicida a partir de la percepción del hecho violento y su contexto, se reflexiona sobre el sentido de las "fronteras invisibles" en barrios de Medellín (Colombia). Desde un enfoque cualitativo que combina revisión documental y entrevistas, se analiza la experiencia vivida por ocho participantes. Entre los principales resultados se destaca que el control barrial es ejercido por distintos actores; que las fronteras no son visibles para el común de las personas, sino que son demarcaciones en las que son reclutadas y controladas, y que consolidan estrategias para recaudar recursos económicos de forma ilegal y regular las actividades culturales y sociales de los habitantes, lo cual repercute en la dinámica y los imaginarios sociales. De este modo, se controlan los territorios, las amistades y los afectos de víctimas jóvenes -que no se vinculan a grupos ilegales y/o no tienen "información"- y de adultos mayores indefensos.

As part of a research study undertaken in the period 2003-2011 to understand situations of homicidal violence based in perceptions regarding the act of violence and the surrounding context, we reflect on the meaning of "invisible bourdaries" in the neighborhoods of Medellin (Colombia). Using a qualitative approach that combines documentary sources and interviews, the experiences of 8 participants are analyzed. In the primary results we can see how control over neighborhoods is exercised by different actors through bourdaries not visible to ordinary people. Nevertheless, around these lines people are recruited and controlled and strategies to illegally generate economic resources and to regulate the cultural and social activities of inhabitants are consolidated, thus affecting the social dynamics and imaginary of the neighborhood. In this way, the territories, friendships, and affects of young victims - who are not linked to illegal groups and/or do not have "information" - and of defenseless older adults are controlled.

Delimitación de fronteras como estrategia de control social: el caso de la violencia homicida en Medellín, Colombia / Marking bourdaries as a strategy of social control: the case of homicidal violence in Medellin, Colombia

En el marco de un estudio realizado entre 2003 y 2011 para comprender escenarios de violencia homicida a partir de la percepción del hecho violento y su contexto, se reflexiona sobre el sentido de las "fronteras invisibles" en barrios de Medellín (Colombia). Desde un enfoque cualitativo que combina revisión documental y entrevistas, se analiza la experiencia vivida por ocho participantes. Entre los principales resultados se destaca que el control barrial es ejercido por distintos actores; que las fronteras no son visibles para el común de las personas, sino que son demarcaciones en las que son reclutadas y controladas, y que consolidan estrategias para recaudar recursos económicos de forma ilegal y regular las actividades culturales y sociales de los habitantes, lo cual repercute en la dinámica y los imaginarios sociales. De este modo, se controlan los territorios, las amistades y los afectos de víctimas jóvenes -que no se vinculan a grupos ilegales y/o no tienen "información"- y de adultos mayores indefensos.(AU)

As part of a research study undertaken in the period 2003-2011 to understand situations of homicidal violence based in perceptions regarding the act of violence and the surrounding context, we reflect on the meaning of "invisible bourdaries" in the neighborhoods of Medellin (Colombia). Using a qualitative approach that combines documentary sources and interviews, the experiences of 8 participants are analyzed. In the primary results we can see how control over neighborhoods is exercised by different actors through bourdaries not visible to ordinary people. Nevertheless, around these lines people are recruited and controlled and strategies to illegally generate economic resources and to regulate the cultural and social activities of inhabitants are consolidated, thus affecting the social dynamics and imaginary of the neighborhood. In this way, the territories, friendships, and affects of young victims - who are not linked to illegal groups and/or do not have "information" - and of defenseless older adults are controlled.(AU)

Delimitación de fronteras como estrategia de control social: el caso de la violencia homicida en Medellín, Colombia. / [Marking bourdaries as a strategy of social control: the case of homicidal violence in Medellin, Colombia].

As part of a research study undertaken in the period 2003-2011 to understand situations of homicidal violence based in perceptions regarding the act of violence and the surrounding context, we reflect on the meaning of "invisible bourdaries" in the neighborhoods of Medellin (Colombia). Using a qualitative approach that combines documentary sources and interviews, the experiences of 8 participants are analyzed. In the primary results we can see how control over neighborhoods is exercised by different actors through bourdaries not visible to ordinary people. Nevertheless, around these lines people are recruited and controlled and strategies to illegally generate economic resources and to regulate the cultural and social activities of inhabitants are consolidated, thus affecting the social dynamics and imaginary of the neighborhood. In this way, the territories, friendships, and affects of young victims ¡ who are not linked to illegal groups and/or do not have "information" ¡ and of defenseless older adults are controlled.

Fortalezas y debilidades del programa para la detección y el control del cáncer cervicouterino. Evaluación cualitativa en San Luis Potosí, México / Strengths and weaknesses of a cervical cancer detection and control program: a qualitative evaluation in San Luis Potosi, Mexico

Objetivo Identificar, desde la perspectiva del personal de salud, las fortalezas y debilidades del programa para la detección y el control del cáncer cervicouterino mediante una evaluación cualitativa, en tres centros de salud de San Luis Potosí, México, entre agosto de 2008 y noviembre de 2009.MétodosSe realizó una evaluación cualitativa. En el estudio participaron nueve prestadores de servicios, seleccionados mediante muestreo por conveniencia, bajo el criterio de participación voluntaria. Inicialmente se obtuvo información de los centros de salud para conocer las características y el contexto en que opera el programa; posteriormente, a los nueve informantes se les realizaron 18 entrevistas semiestructuradas para indagar su perspectiva. Se empleó un análisis de contenido dirigido. Resultados Las fortalezas referidas por el personal son el carácter gratuito del programa, la disponibilidad de recursos materiales, así como algunas estrategias que facilitan la captación de mujeres y su acceso al cribado. Las principales debilidades son las limitaciones de recursos humanos y en la estructura física, la ineficiente organización de actividades, la deficiente capacidad técnica del personal y las limitadas acciones de promoción, así como las dificultades en el seguimiento de las mujeres con resultados positivos. Conclusiones Este estudio muestra la necesidad de incrementar los recursos humanos, realizar cambios en la normatividad y reorganizar las acciones del programa en algunos centros de salud, para garantizar la calidad del servicio y satisfacer los requerimientos de las mujeres, y así favorecer la cobertura en todas sus acciones (AU)

Objective To identify, from the perspective of the health staff, the strengths and weaknesses of the program for the detection and control of cervical cancer through a qualitative assessment implemented in three health centers in the city of San Luis Potosi, Mexico, from August 2008 to November 2009.MethodsA qualitative evaluation was performed. Nine providers participated in the study. The providers were selected by purposeful sampling using a voluntary participation criterion. Initially, information on the characteristics and the context in which the program operates was obtained from the health centers. Later, 18 semi-structured interviews were conducted with nine informants to probe their perspective. A directed content analysis was used. Results The strengths reported by staff were the fact that the program is free of charge, the availability of material resources, and the strategies that helped encourage the recruitment of women and their access to screening. The main weaknesses consisted of limitations in human resources and physical infrastructure, inefficient organization of activities, the staff's poor technical training, limited promotion of activities, and limitations in monitoring women with positive results. Conclusions This study reveals the need for increased human resources, changes in regulations and reorganization of the program's actions in some health centers to ensure the quality of the service, meet women's needs, and promote coverage in all the program's actions (AU)

[Strengths and weaknesses of a cervical cancer detection and control program: a qualitative evaluation in San Luis Potosi, Mexico]. / Fortalezas y debilidades del programa para la detección y el control del cáncer cervicouterino. Evaluación cualitativa en San Luis Potosí, México.

OBJECTIVE: To identify, from the perspective of the health staff, the strengths and weaknesses of the program for the detection and control of cervical cancer through a qualitative assessment implemented in three health centers in the city of San Luis Potosi, Mexico, from August 2008 to November 2009. METHODS: A qualitative evaluation was performed. Nine providers participated in the study. The providers were selected by purposeful sampling using a voluntary participation criterion. Initially, information on the characteristics and the context in which the program operates was obtained from the health centers. Later, 18 semi-structured interviews were conducted with nine informants to probe their perspective. A directed content analysis was used. RESULTS: The strengths reported by staff were the fact that the program is free of charge, the availability of material resources, and the strategies that helped encourage the recruitment of women and their access to screening. The main weaknesses consisted of limitations in human resources and physical infrastructure, inefficient organization of activities, the staff's poor technical training, limited promotion of activities, and limitations in monitoring women with positive results. CONCLUSIONS: This study reveals the need for increased human resources, changes in regulations and reorganization of the program's actions in some health centers to ensure the quality of the service, meet women's needs, and promote coverage in all the program's actions.

Caer en la trampa: el accidente por mina antipersonal: la experiencia de los sobrevivientes, Antioquia, Colombia, 2007 / Caught in the trap: survivors’ experiences after landmine accidents, Antioquia, Colombia, 2007

Objetivo: este artículo es el resultado parcial de una investigación llevada a cabo en el contexto de la formación en una maestría en el área de la salud colectiva, cuyo propósito fue interpretar el proceso de integración a la vida cotidiana de los sobrevivientes a accidentes por mina antipersonal, a través de sus relatos para la reconstrucción de experiencias. Metodología: el estudio se hizo con un abordaje metodológico cualitativo etnográfico particularista y focalizado; como técnicas para recolectar la información se utilizaron la entrevista semiestructurada a cuatro participantes y la observación durante la misma. Resultados: en esta publicación se muestra la categoría caer en la trampa, en respuesta a la pregunta ¿cuál es la experiencia con el accidente de los sobrevivientes de minas antipersonal?, que describe el momento de la explosión e incluye el lugar donde sucedió, la actividad que realizaban en ese momento, el objeto con el que fueron heridos, los daños y las sensaciones que les produjo tanto a sí mismos como a sus acompañantes. Conclusiones: la educación en el riesgo de minas es una estrategia adecuada para asegurar que las personas y comunidades se sensibilicen sobre los riesgos, reduciéndolos a un nivel en el que puedan recrear un entorno libre de las limitaciones impuestas por su presencia.

Objective: This report is the partial result of a survey carried out with the purpose of interpreting the process of reintegration to daily life of survivors after landmine accidents, through their testimonies when they recall their experiences.Methodology: A qualitative methodological approach and an ethnographic particularistic focus were employed.The techniques for gathering information were semis tructured interviews to four participants, and observations during them.Results: This paper shows the category caught in the trap in response to the question: How is the experience of landmine accidents survivors? It describes the moment and place of the blast, the activity that was being carried out, the object responsible for the injuries, the harm caused, and the sensations of the survivors and their companions.Conclusions: Education on the risk of landmines is an adequate strategy to make communities and persons aware of the dangers posed by those artifacts.Consequently, the possibility arises to reduce such dangers to levels consistent with the recreation of milieus free from the restrictions imposed by the presence of landmines.

Escenarios de violencia: interpretación de las lesiones no fatales, Colombia / Scenarios of violence: interpretation of nonfata injuries, Colombia

Objetivo: construir escenarios de violencia por lesiones intencionales no fatales en el departamento de Antioquia, Colombia, a partir de casos atendidos en 12 hospitales de diferentes niveles de atención, en 2007. Métodos: Se combinaron elementos de distintos enfoques cualitativos que permiten describir el contexto (etnografía); hacer una doble interpretación de los hechos, desde el actor y el investigador (hermenéutica), y construir los escenarios de violencia, mediante entrevistas a 87 lesionados en hechos violentos. Resultados: La mayoría de las agresiones ocurrieron en hombres, de 20 a 49 años de edad, residentes en áreas urbanas, trabajadores informales; sucedieron entre viernes y domingo, en medio de una riña en la vía pública o en un establecimiento público; fueron ocasionadas por armas cortopunzantes, cortantes o contundentes, y fueron por un conocido, amigo o familiar. Los escenarios construidos ayudan a comprender el fenómeno de la violencia en el departamento y las diferencias entre regiones. Estos fueron: apropiación de bienes, reivindicación económica o moral, lesión por azar, conflictos personales, control social, fracaso en la tramitación de los conflictos dentro de la familia, agresión a símbolo identitario, sobrevivencia y coexistencia de prácticas o normas con actores armados. Conclusión: Con los escenarios se identifican procesos sociales fundamentales; sin embargo, su delimitación no es definitiva, hay imbricaciones entre ellos, lo que muestra su complejidad en el departamento...

Objective: To build scenarios of violence caused by nonfatal intentional injuries in the Province of Antioquia (Colombia), based on cases managed in 12 hospitals of different care levels in 2007. Methodology: Different qualitative approach elements were combined to allow describing the context (ethnography); to make double interpretation of the events, from the actor and the investigator (hermeneutics), and to construct the scenarios of violence by means of inteviews with 87 subjects injured in violent events. Results: Most of the aggressions occurred in males between 20 and 49 years of age, living in urban areas and with no formal employment. The attacks happened between Friday and Sunday, in the middle of a fight in the street or a public establishment. The injuries were caused by stabbing, slashing or blunt weapons and usually by sombody known to the victim, a friend or a relative. Such scenarios help to understand the violence in Antioquia and the differences between regions. These were: conversion, economic or moral claim, random injury, personal conflicts, social control, failure in managing intra-family conflicts, aggression as an identity symbol, survival and coexistence of practices or norms with armed actors. Conclusion: By means of these scenarios fundamental social processes are identified. However, their boundaries are not definitive overlappings exist between them, showing their complexity in this Province...

Efectividad de un programa educativo en el control del enfermo con diabetes / Effectiveness of an educational program in the control of diabetic patients

Objetivo: evaluar la efectividad de un programa de intervención educativa dirigido a personas con diabetes mellitus tipo 2 en una Unidad de Medicina Familiar de San Luis Potosí, México. Metodología: es un estudio de intervención, longitudinal, comparativo; se utilizó muestreo probabilístico de tipo sistemático con asignación aleatoria. Las variables de estudio fueron: el nivel de conocimientos respecto a la enfermedad y el autocuidado y el control metabólico del enfermo. Al grupo de estudio se le aplicó un programa de intervención educativa durante nueve meses y el grupo control recibió la asistencia convencional establecida en la unidad de atención; a ambos grupos se les realizaron mediciones de hemoglobina glucosilada y del nivel de conocimientos antes y después de la intervención. Los datos se procesaron y analizaron mediante el paquete SPSS 8.0. Se aplicaron medidas de estadística descriptiva e inferencial. Resultados y Discusión: los resultados mostraron evidencia estadística de la efectividad del programa educativo ya que mejoró el nivel de conocimientos y porque a través de la prueba de Friedman se mostró que el promedio de hemoglobina glucosilada era menor en el grupo de estudio. Conclusiones: el programa evaluado es efectivos al favorecer tanto el incremento del nivel de los conocimientos sobre la enfermedad, las medidas para el control y la terapéutica, como el control metabólico del paciente.