Differential Gene Expression Patterns in Peach Roots under Non-Uniform Soil Conditions in Response to Organic Matter.

Organic matter (OM) amendments are often encouraged in sustainable agriculture programs but can create heterogeneous soil environments when applied to perennial crops such as peaches (Prunus persica (L.) Batsch). To better understand the responses of peach roots to non-uniform soil conditions, transcriptomic analysis was performed in a split-root study using uniform soil (the same soil type for all roots) or non-uniform soil (different soil types for each half of the root system) from either (1) autoclaved sand (S), (2) autoclaved sand with autoclaved compost (A), or (3) autoclaved sand with compost which included inherent biological soil life (B). Each uniform soil type (S, A, and B) was grouped and compared by uniform and non-uniform soil comparisons for a total of nine treatments. Comparisons revealed peach roots had differentially expressed genes (DEGs) and gene ontology terms between soil groups, with the S and B groups having a range of 106-411 DEGs and the A group having a range of 19-94 DEGs. Additionally, six modules were identified and correlated (p > 0.69) for six of the nine treatment combinations. This study broadly highlights the complexity of how OM and biological life in the rhizosphere interact with immediate and distant roots and sheds light on how non-homogenous soil conditions can influence peach root gene expression.

Ppe.RPT/SSC-1: from QTL mapping to a predictive KASP test for ripening time and soluble solids concentration in peach.

Genomic regions associated with ripening time (RPT) and soluble solids concentration (SSC) were mapped using a pedigreed population including multiple F1 and F2 families from the Clemson University peach breeding program (CUPBP). RPT and SSC QTLs were consistently identified in two seasons (2011 and 2012) and the average datasets (average of two seasons). A target region spanning 10,981,971-11,298,736 bp on chromosome 4 of peach reference genome used for haplotype analysis revealed four haplotypes with significant differences in trait values among different diplotype combinations. Favorable alleles at the target region for both RPT and SSC were determined and a DNA test for predicting RPT and SSC was developed. Two Kompetitive Allele Specific PCR (KASP) assays were validated on 84 peach cultivars and 163 seedlings from the CUPBP, with only one assay (Ppe.RPT/SSC-1) needed to predict between early and late-season ripening cultivars and low and high SSC. These results advance our understanding of the genetic basis of RPT and SSC and facilitate selection of new peach cultivars with the desired RPT and SSC.

Transcriptomics reveal the genetic coordination of early defense to Armillaria root rot (ARR) in Prunus spp.

Armillaria root rot (ARR) poses a significant threat to the long-term productivity of stone-fruit and nut crops in the predominant production area of the United States. To mitigate this issue, the development of ARR-resistant and horticulturally-acceptable rootstocks is a crucial step towards the maintenance of production sustainability. To date, genetic resistance to ARR has been found in exotic plum germplasm and a peach/plum hybrid rootstock, 'MP-29'. However, the widely-used peach rootstock Guardian® is susceptible to the pathogen. To understand the molecular defense mechanisms involved in ARR resistance in Prunus rootstocks, transcriptomic analyses of one susceptible and two resistant Prunus spp. were performed using two causal agents of ARR, including Armillaria mellea and Desarmillaria tabescens. The results of in vitro co-culture experiments revealed that the two resistant genotypes showed different temporal response dynamics and fungus-specific responses, as seen in the genetic response. Gene expression analysis over time indicated an enrichment of defense-related ontologies, including glucosyltransferase activity, monooxygenase activity, glutathione transferase activity, and peroxidase activity. Differential gene expression and co-expression network analysis highlighted key hub genes involved in the sensing and enzymatic degradation of chitin, GSTs, oxidoreductases, transcription factors, and biochemical pathways likely involved in Armillaria resistance. These data provide valuable resources for the improvement of ARR resistance in Prunus rootstocks through breeding.

Ppe.CR.1 DNA test for predicting chilling requirement in peach.

Chilling requirement (CR) is an important agronomic trait controlling the floral bud break for proper flowering in peach. Even though it has been widely researched and several peach CR quantitative trait loci (QTLs) have been identified, no diagnostic DNA tests validated in the U.S. peach breeding germplasm are available for this trait. Breeders and growers need a simple DNA test to predict the CR of peach cultivars for their particular environment. Therefore, we developed a quick and reliable Kompetitive Allele Specific PCR (KASP) DNA test using haplotype information from 9K IPSC genotype data of the U.S. peach germplasm integrating four CR-associated SNP markers from the previously reported CR QTL region on linkage group 1. Four KASP assays (Ppe.CR.1-1 to -4) were developed and validated on 77 peach cultivars, and nine accessions from two F2 populations, with 96 and 74% accuracy in determining expected CR genotype (compared to SNP array) and predicting phenotype, respectively. Furthermore, the Ppe.CR.1 showed 80% accuracy in predicting the precise CR phenotype in the Clemson University peach breeding material. Only one Ppe.CR.1 KASP assay (Ppe.CR.1-1) is needed to distinguish between haplotypes with CR lower and higher than 800 chilling hours, and two Ppe.CR.1 assays (Pp.CR.1-1 and -4), are capable of distinguishing low, moderate, and high CR alleles. Coupled with the crude DNA extraction, the Ppe.CR.1 DNA test provides a low-cost option for breeders and growers to predict CR in peach material with more than 70% accuracy.

El cuidado y la mujer-cuidadora: su construcción televisiva en los programas de salud en Colombia / Care and the woman-caregiver: its television construction in health shows in Colombia / O cuidado e a mulher-cuidadora: sua construção televisiva nos programas de saúde na Colômbia

Resumen Introducción: La televisión ha tenido (y lo sigue haciendo) un papel importante en la construcción de sentidos en torno a la salud y el cuidado. Cada vez surgen más programas televisivos que, desde sus diferentes formatos (telenovelas, noticieros, magazines, etcétera), abordan desde diversos ángulos y narrativas la relación entre ambos conceptos. Objetivo: develar cómo la televisión colombiana por medio de algunos programas enfocados en la salud representa el cuidado. Metodología: fue cualitativa de alcance exploratorio. Se realizó un análisis textual de 68 episodios de tres programas de televisión colombianos entre 2013 y 2014 y se entrevistaron a 10 productores de contenidos audiovisuales en salud. Resultados: estos evidenciaron que dichos programas sitúan el cuidado en el marco de la prevención de la enfermedad y la promoción de la salud, contexto en el cual la mujer "ama de casa" juega un papel central debido a que es la "receptora natural" de los contenidos audiovisuales. No obstante, mientras los programas de salud responsabilizan a las mujeres del cuidado propio y de los demás, al mismo tiempo deslegitiman su conocimiento frente al saber técnico especializado de los profesionales de la salud biomédica. Conclusión: los productores y los mensajes televisivos reproducen y naturalizan la feminización del cuidado.

Abstract Introduction: Television has played (and continues to play) an important role in the production of meanings around health and care. More and more television programs are emerging that, from their different formats (soap operas, newscasts, magazines, etc.), address the relationship between both concepts from different angles and narratives. Objective: to reveal how, through some programs focused on health, Colombian television represents care. Methodology: Qualitative with an exploratory scope. A textual analysis of 68 episodes of three Colombian television programs between 2013 and 2014 was carried out and 10 producers of audiovisual health content were interviewed. Results: these shows demonstrated that such programs place care within the framework of disease prevention and health promotion, a context in which the "housewife" woman plays a central role because she is the "natural recipient" of the audiovisual content. However, while health programs make women responsible for the care of themselves and others, at the same time they delegitimize their knowledge in the face of the specialized technical knowledge of biomedical health professionals. Conclusion: producers and television messages reproduce and naturalize the feminization of care.

Resumo Introdução: A televisão tem tido (e o segue fazendo) um papel importante na construção de sentidos no âmbito à saúde e o cuidado. Cada vez surgem mais programas televisão que, desde seus diferentes formatos (telenovelas, tv jornais, magazines, etc.), abordam desde diversos ângulos e narrativas a relação entre ambos conceitos. Objetivo: debelar como a televisão colombiana por meio de alguns programas enfocados na saúde representa o cuidado. Metodologia: foi qualitativa de alcance exploratório. Realizou-se uma análise textual de 68 episódios de três programas de televisão colombianos entre 2013 e 2014 e se entrevistaram a 10 produtores de conteúdos audiovisuais em saúde. Resultados: estes evidenciaram que ditos programas situam o cuidado no marco da prevenção da doença e a promoção da saudade, contexto no qual a mulher "dona de casa" joga um papel central devido a que é a "receptora natural" dos conteúdos audiovisuais. Não obstante, em quanto os programas de saúde responsabilizam às mulheres do cuidado próprio e dos outros, ao mesmo tempo deslegitimam seu conhecimento frente ao saber técnico especializado dos professionais da saúde biomédica. Conclusão: os produtores e as mensagens da televisão reproduzem e naturalizam a feminização do cuidado.

Identification of Key Genes Related to Dormancy Control in Prunus Species by Meta-Analysis of RNAseq Data.

Bud dormancy is a genotype-dependent mechanism observed in Prunus species in which bud growth is inhibited, and the accumulation of a specific amount of chilling (endodormancy) and heat (ecodormancy) is necessary to resume growth and reach flowering. We analyzed publicly available transcriptome data from fifteen cultivars of four Prunus species (almond, apricot, peach, and sweet cherry) sampled at endo- and ecodormancy points to identify conserved genes and pathways associated with dormancy control in the genus. A total of 13,018 genes were differentially expressed during dormancy transitions, of which 139 and 223 were of interest because their expression profiles correlated with endo- and ecodormancy, respectively, in at least one cultivar of each species. The endodormancy-related genes comprised transcripts mainly overexpressed during chilling accumulation and were associated with abiotic stresses, cell wall modifications, and hormone regulation. The ecodormancy-related genes, upregulated after chilling fulfillment, were primarily involved in the genetic control of carbohydrate regulation, hormone biosynthesis, and pollen development. Additionally, the integrated co-expression network of differentially expressed genes in the four species showed clusters of co-expressed genes correlated to dormancy stages and genes of breeding interest overlapping with quantitative trait loci for bloom time and chilling and heat requirements.

Thermoregulation of Liolaemus aparicioi (Iguania: Liolaemidae) along a 1000 m elevational gradient in La Paz Valley, La Paz, Bolivia.

Lizard species have diverse behavioral and physiological responses to thermo-environmental conditions, which allow them to inhabit a broad range of latitudes and elevations. Because the availability of suitable thermal resources is limited and more variable at high-elevation environments than at lower elevations, we expect high-elevation lizards to be constrained in their thermoregulation relative to lizards at lower elevations by the fewer available thermal resources to reach optimal temperatures (colder environment). We studied the thermal biology of an endemic and Critically Endangered lizard, Liolaemus aparicioi, to assess its thermal responses along a 1000 m elevational gradient in La Paz Valley from May to August of 2015 (dry season). We took field body and microhabitat temperatures at capture sites (substrate and air above ground), and body size (snout-vent length and mass) of individuals at Taypichullo (3000 m asl), Gran Jardín de la Revolución Municipal Park (3500 m asl), and Taucachi (4000 m asl) localities. Operative temperatures were taken from calibrated models deployed in different available microhabitats. Preferred temperatures and thermal tolerance limits were determined in laboratory settings for lizards from each locality. Field body, microhabitat, and operative temperatures decreased with increasing elevation and differed between sexes. Lizards at the high elevation locality had the lowest thermoregulatory efficiency as compared with the mid and lower elevation localities. In laboratory measurements, while the preferred temperatures varied between sexes, pooled preferred temperatures and thermal tolerances were similar in all localities. Although thermal resources at high elevation can limit thermoregulatory possibilities in L. aparicioi, behavioral microhabitat use, time allocated to thermoregulation, and physiological adjustments seem to be possible strategies to counteract thermal costs along elevational gradients.

Identification and Characterization of DAMs Mutations Associated With Early Blooming in Sweet Cherry, and Validation of DNA-Based Markers for Selection.

Dormancy release and bloom time of sweet cherry cultivars depend on the environment and the genotype. The knowledge of these traits is essential for cultivar adaptation to different growing areas, and to ensure fruit set in the current climate change scenario. In this work, the major sweet cherry bloom time QTL qP-BT1.1 m (327 Kbs; Chromosome 1) was scanned for candidate genes in the Regina cv genome. Six MADS-box genes (PavDAMs), orthologs to peach and Japanese apricot DAMs, were identified as candidate genes for bloom time regulation. The complete curated genomic structure annotation of these genes is reported. To characterize PavDAMs intra-specific variation, genome sequences of cultivars with contrasting chilling requirements and bloom times (N = 13), were then mapped to the 'Regina' genome. A high protein sequence conservation (98.8-100%) was observed. A higher amino acid variability and several structural mutations were identified in the low-chilling and extra-early blooming cv Cristobalina. Specifically, a large deletion (694 bp) upstream of PavDAM1, and various INDELs and SNPs in contiguous PavDAM4 and -5 UTRs were identified. PavDAM1 upstream deletion in 'Cristobalina' revealed the absence of several cis-acting motifs, potentially involved in PavDAMs expression. Also, due to this deletion, a non-coding gene expressed in late-blooming 'Regina' seems truncated in 'Cristobalina'. Additionally, PavDAM4 and -5 UTRs mutations revealed different splicing variants between 'Regina' and 'Cristobalina' PavDAM5. The results indicate that the regulation of PavDAMs expression and post-transcriptional regulation in 'Cristobalina' may be altered due to structural mutations in regulatory regions. Previous transcriptomic studies show differential expression of PavDAM genes during dormancy in this cultivar. The results indicate that 'Cristobalina' show significant amino acid differences, and structural mutations in PavDAMs, that correlate with low-chilling and early blooming, but the direct implication of these mutations remains to be determined. To complete the work, PCR markers designed for the detection of 'Cristobalina' structural mutations in PavDAMs, were validated in an F2 population and a set of cultivars. These PCR markers are useful for marker-assisted selection of early blooming seedlings, and probably low-chilling, from 'Cristobalina', which is a unique breeding source for these traits.

Multiple-population QTL mapping of maturity and fruit-quality traits reveals LG4 region as a breeding target in sweet cherry (Prunus avium L.).

Sweet cherry maturity date and fruit quality are relevant traits for its marketability, transport, and consumer acceptance. In this work, sweet cherry fruit development time, maturity date, and commercial fruit-quality traits (size, weight, firmness, soluble solid content, and titratable acidity) were investigated to improve the knowledge of their genetic control, and to identify alleles of breeding interest. Six sweet cherry populations segregating for these traits were used for QTL analyses. These populations descend from cross- and self-pollinations of local Spanish sweet cherries 'Ambrunés' and 'Cristobalina', and breed cultivars ('Brooks', 'Lambert', or 'Vic'). The six populations (n = 411), previously genotyped with RosBREED Cherry 6 K SNP array, were phenotyped for 2 years. QTL analyses were conducted using a multifamily approach implemented by FlexQTL™. Fruit development time, soluble solid content, and titratable acidity QTLs are first reported in sweet cherry in this work. Significant QTLs were detected for all the traits. Eighteen were more stable as they were detected for 2 years. Of these, nine are first reported in this work. The major QTLs for fruit development time, maturity date, firmness, and soluble solid content were identified on the same narrow region of linkage group 4. These traits also showed significant positive correlation (long fruit development time associated with late maturity, high firmness, and high SSC). NAC transcription factor genes identified on this LG4 region may be candidate genes for the regulation of these traits in sweet cherry, as previously described in syntenic regions of other Rosaceae species. Haplotypes of breeding interest on this LG4 genomic region were identified and will be useful for sweet cherry breeding from this and related plant material.

Philodryas (Serpentes: Dipsadidae) Envenomation, a Neglected Issue in Chile.

Snakebite envenomation is considered a neglected tropical disease, although it also occurs outside the tropics. In this work, we analyzed the literature on Philodryas species in Chile (Philodryaschamissonis, P.simonsii, and P.tachymenoides) from 1834 to 2019, searching for epidemiological, clinical, and molecular aspects of envenomation. Ninety-one percent of the studies found regarded taxonomy, ecology, and natural history, suggesting that snakebites and venom toxins are a neglected issue in Chile. All snakebite cases reported and toxicological studies concerned the species Philodryaschamissonis. Using 185 distributional records from the literature and museum collections for this species, we show for the first time that the reported snakebite cases correlate with human population density, occurring in the Valparaiso and Metropolitan regions in Central Chile. The reduced number of snakebite cases, which were previously considered as having a low incidence in Chile, may be a consequence of under-reported cases, probably due to the inadequate publication or scarce research on this issue. Absence of information about official pharmacological treatment, post-envenoming sequels, clinical management of particular patient groups (e.g., with non-communicable diseases, pregnant women, and the elderly) was also detected. In conclusion, despite having over 185 years of literature on Chilean snakes, knowledge on the envenomation of Philodryas genus remains scarce, seriously affecting adequate medical handling during an ophidic accident. This review highlights the need to develop deep research in this area and urgent improvements to the management of this disease in Chile.

Genetic Dissection of Bloom Time in Low Chilling Sweet Cherry (Prunus avium L.) Using a Multi-Family QTL Approach.

Bloom time in sweet cherry (Prunus avium L.) is a highly heritable trait that varies between genotypes and depends on the environmental conditions. Bud-break occurs after chill and heat requirements of each genotype are fulfilled, and dormancy is released. Bloom time is a critical trait for fruit production as matching cultivar adaptation to the growing area is essential for adequate fruit set. Additionally, low chilling cultivars are of interest to extend sweet cherry production to warmer regions, and for the crop adaptation to increasing winter and spring temperatures. The aim of this work is to investigate the genetic control of this trait by analyzing multiple families derived from the low chilling and extra-early flowering local Spanish cultivar 'Cristobalina' and other cultivars with higher chilling requirements and medium to late bloom times. Bloom time evaluation in six related sweet cherry populations confirmed a high heritability of this trait, and skewed distribution toward late flowering, revealing possible dominance of the late bloom alleles. SNP genotyping of the six populations (n = 406) resulted in a consensus map of 1269 SNPs. Quantitative trait loci (QTL) analysis using the Bayesian approach implemented by FlexQTL™ software revealed two major QTLs on linkage groups 1 and 2 (qP-BT1.1m and qP-BT2.1m) that explained 47.6% of the phenotypic variation. The QTL on linkage group 1 was mapped to a 0.26 Mbp region that overlaps with the DORMANCY ASSOCIATED MADS-BOX (DAM) genes. This finding is consistent with peach results that indicate that these genes are major determinants of chilling requirement in Prunus. Haplotype analysis of the linkage group 1 and 2 QTL regions showed that 'Cristobalina' was the only cultivar tested that contributed early bloom time alleles for these two QTLs. This work contributes to knowledge of the genetic control of chilling requirement and bloom date and will enable marker-assisted selection for low chilling in sweet cherry breeding programs.

[Persistent abdominal pain caused by superior mesenteric artery and celiac trunk dissection that does not respond to conservative treatment]. / Dolor abdominal persistente por disección de arteria mesentérica superior y tronco celiaco, que no responde a tratamiento conservador.

We report the case of a 32 year old male with recurrent colic abdominal pain due to superior mesenteric artery (SMA) and celiac trunk dissection, which resolved after placing 3 stents in SMA. The patient presented atypical clinical signs and symptoms, which made the diagnosis difficult. Clinical presentation, diagnostic methods and treatment options are discussed. We started with conservative management with pain medication, anticoagulation, antihypertensive drugs and image control, but on the seventh day, after restarting oral ingestion, he presented with abdominal angina, after which we proceeded to endovascular treatment with successful results and with an uneventfully 2 year follow up.

Dolor abdominal persistente por disección de arteria mesentérica superior y tronco celiaco, que no responde a tratamiento conservador / Persistent abdominal pain caused by superior mesenteric artery and celiac trunk dissection that does not respond to conservative treatment

Reportamos el caso de un paciente varón de 32 años con dolor abdominal recurrente tipo cólico a causa de disección de arteria mesentérica superior (AMS) y tronco celíaco, el cual se resolvió luego de la colocación de 3 stents en AMS. El paciente presentó una clínica atípica lo cual dificultó el diagnóstico. Discutimos la clínica, métodos diagnósticos y alternativas de tratamiento. Iniciamos con un manejo conservador con analgesia, anticoagulación plena, antihipertensivo y control de imágenes, pero al séptimo día luego de reiniciar la vía oral, presenta angina abdominal, por lo cual procedimos a tratamiento endovascular con resultado exitoso y buena evolución, sin eventos, a un seguimiento de 2 años

We report the case of a 32 year old male with recurrent colic abdominal pain due to superior mesenteric artery (SMA) and celiac trunk dissection, which resolved after placing 3 stents in SMA. The patient presented atypical clinical signs and symptoms, which made the diagnosis difficult. Clinical presentation, diagnostic methods and treatment options are discussed. We started with conservative management with pain medication, anticoagulation, antihypertensive drugs and image control, but on the seventh day, after restarting oral ingestion, he presented with abdominal angina, after which we proceeded to endovascular treatment with successful results and with an uneventfully 2 year follow up

Probing the role of excited states in ionization of acetylene.

Ionization of acetylene by linearly-polarized, vacuum ultraviolet (VUV) laser pulses is modelled using time-dependent density functional theory. Several laser wavelengths are considered including one that produces direct ionization to the first excited cationic state while another excites the molecules to a Rydberg series incorporating an autoionizing state. We show that for the wavelengths and intensities considered, ionization is greatest whenever the molecule is aligned along the laser polarization direction. By considering high harmonic generation we show that populating excited states can lead to a large enhancement in the harmonic yield. Lastly, angularly-resolved photoelectron spectra are calculated which show how the energy profile of the emitted electrons significantly changes in the presence of these excited states.

Enfermedad oclusiva aorto-iliaca: del tratamiento quirúrgico al endovascular / Aorto-Iliac Occlusive disease: from surgical to endovascular treatment

Evaluar y comparar los resultados del tratamiento para la enfermedad oclusiva aorto-iliaca (EOAI) mediante la técnica quirúrgica, endovascular o híbrida. Material y métodos: Estudio retrospectivo, descriptivo se revisaron las historias clínicas de 50 pacientes tratados consecutivamente entre marzo 1993 y diciembre 2014. Se dividió a los pacientes en 3 grupos, según tratamiento recibido: Quirúrgico (Grupo Q), Endovascular (Grupo E) e Híbrido (Grupo H) y se evaluó el manejo y evolución en cada grupo de acuerdo al tipo de lesión (Clasificación TASC). Resultados: La revascularización de la EOAI fue exitosa en todos los casos, a excepción de una paciente con oclusión aguda aorto-iliaca post cateterismo de la aorta que falleció por embolismo masivo agudo. Este fue el único caso de mortalidad postoperatoria. En el seguimiento de 48,5 meses (rango: 1 - 204 meses), desaparecieron los síntomas en todos los pacientes. La permeabilidad primaria y secundaria fue 69% y 92% en el grupo Q y 100% en el grupo E. La mortalidad tardía fue de 2 casos en el grupo Q, ninguna en E y 1 en H. Conclusiones: Nuestra serie muestra resultado exitoso utilizando ambas técnicas: quirúrgica o endovascular para el tratamiento de la EOAI tanto a 30 días como a 4 años de seguimiento. Los resultados son similares a publicaciones internacionales. Las lesiones menos complejas fueron más frecuentemente tratadas con técnica endovascular con buenos resultados. Es crucial utilizar doppler pletismografía arterial de reposo y ejercicio para detectar los casos sintomáticos en estadíos tempranos (menos complicados)...

To assess early and late outcomes among different treatment techniques in patients with Aortoiliac Occlusive Disease (AIOD) and compare surgical, endovascular and hybrid technique. Methods: We have retrospectively analyzed records of 50 consecutive patients treated from March, 1993 to December, 2014. We divided them in 3 groups: Surgical (Q Group), Endovascular (E Group) and Hybrid treatment (H group). Successful revascularization was achieved with both surgical and endovascular techniques. Results: Clinical and technical success was achieved in all cases but one, who presented acute aortic occlusion. This was the only in-hospital postoperative mortality case due to acute massive athero-embolism post endovascular procedure. During 48.5 months follow up (1 - 204 months) there was no recurrence of symptoms. Primary and Secondary Patency was of 69% and 92% on Q group and 100% on E group. Late mortality was of2 cases in Q Group, none on E Group and 1 on H Group. Conclusions: Our series show successful outcomes using either endovascular or surgical techniques to treat ATOO at 30 days and 4 years follow up. Our results are similar to those published on international studies. Less complex lesions were treated mostly with endovascular techniques with good results. It is crucial to perform Arterial Doppler plethismography at rest and post exercise in order to detect these cases in early stages...

Modalidades de interacción en el régimen subsidiado de salud en medellín: participación y estrategias sociales / Modalities of interaction in the health subsidized regime in medellin: participation and social strategies / Modalidades de interação no régimen subsidiado de saúde Em Medellín: participação e estrategias sociais

Objetivos: identificar las concepciones y acciones de participación de usuarios y personal del Régimen Subsidiado en Medellín. Materiales y Métodos: investigación exploratoria que utilizó técnicas cualitativas de recolección y análisis de la información entre octubre de 2009 y marzo de 2010 en cinco Instituciones Prestadoras de Servicios de Salud de Medellín. Se aplicaron entrevistas semiestructuradas a 40 usuarios y 15 funcionarios del Régimen Subsidiado sobre su comprensión de la participación y se identificaron sus estrategias para desenvolverse e involucrarse en el sistema de salud. Se realizó un taller participativo con 15 funcionarios administrativos y asistenciales para indagar por su rol en la promoción de la participación en salud. Resultados: se distinguieron de las acciones en participación otras modalidades de interacción con el sistema, que llamamos estrategias sociales en salud. Las acciones de participación institucionales son a veces ineficientes según los entrevistados, quienes prefieren activar las estrategias sociales más conocidas y efectivas, y no requieren un conocimiento especializado ni una movilización política. Se identificó que la participación y las estrategias sociales en salud se activan mayormente en situaciones dramáticas. Conclusiones: la participación ha sido definida institucionalmente y otras modalidades de interacción e involucramiento han sido desconocidas por el sistema. Es necesario reconocer que, en general, los mecanismos y espacios de participación institucional no están funcionando adecuadamente, y en cambio las estrategias sociales son efectivas. La identificación de este fenómeno puede promover la consolidación de una educación ciudadana en salud y el mejoramiento de los mecanismos institucionales para garantizar el ejercicio de derechos y la corresponsabilidad.

Objectives: To identify the ideas and actions of participation of users and staff of the subsidized insurance health system in Medellin. Materials and Methods: exploratory research using gathering and analysis of information qualitative techniques between October 2009 and March 2010 in five health care institutions in Medellin. Semi-structured interviews were applied to 40 users and 15 employees from the subsidized health care system about their understanding of participation and their strategies to engage and get involved in the health system were identified. A participatory workshop with 15 administrative and welfare staff was conducted to explore their role in the promotion of health participation. Results: participation was differentiated from other forms of interaction with the system, called here social health strategies. Institutional participation actions are sometimes inefficient according to respondents, who prefer to activate known and effective social health strategies that do not require specialized knowledge or a political mobilization. It was identified that participation and social strategies in health are mostly activated after dramatic situations. Conclusions: the participation has been defined institutionally and other modalities of interaction and engagement have been unknown by the system. It is necessary to recognize that, in general, the mechanisms and institutional participation spaces are not working properly, and instead social health strategies are effective. Identification of this phenomenon can promote the consolidation of a citizenship health education and the improvement of the institutional mechanisms to ensure health rights and co-responsibility.

Objetivos: identificar as concepções e ações de participação de usuários e pessoal do Regime Subsidiado em Medellín. Materiais e Métodos: pesquisa exploratória que utilizou técnicas qualitativas de recolheita e analise da informação entre outubro de 2009 e março de 2010 em cinco instituições Prestadoras de Serviços de Saúde de Medellín. Aplicaram se entrevistas semiestruturas a 40 usuários e 15 funcionários do Regime Subsidiado sobre sua compreensão da participação e identificaram se sua estratégias para desembrulhar e envolver se no sistema de saúde. Realizou se um encontró participativo com 15 funcionários administrativos e assistenciais para indagar por seu rol na promoção da participação em saúde. Resultados: distinguiriam se das ações em participação outras modalidades de interação com o sistema, que chamamos estratégias sociais em saúde. As ações de participação institucionais são às vezes ineficientes segundo os entrevistados, quem prefere ativar as estratégias sociais conhecidas e efetivas, e não requerem um conhecimento especializado nem uma mobilização política. Identificaram se que a participação e as estratégias sociais em saúde ativam se, maiormente em situações dramáticas. Conclusões: A participação em sido definida institucionalmente e outras modalidades de interação e envolvimento tem sido desconhecidas pelo sistema. É preciso reconhecer que, em geral, os mecanismos e espaços de participação institucional não estão funcionando adequadamente, e em cambio as estratégias sociais são efetivas. A identificação deste fenômeno pode promover a consolidação duma educação cidadã em saúde e o melhoramento dos mecanismos institucionais para garantir o exercício de direitos e a corresponsabilidade.