Violence Exposure and Disability in Colombian Female Survivors of Intimate Partner Violence: the Mediating Role of Depressive Symptoms.

BACKGROUND: Violence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability. METHODS: This was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2. RESULTS: The direct effect of IPV severity on the level of disability was not statistically significant (ß=0.09; P=0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was (ß=0.39; P<0.01). The total effect of IPV severity on the level of disability was even greater (ß=0.48; P=0.01). CONCLUSIONS: This study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

Seasonal and Temporal Patterns of Homicides and Suicides in Cali and Manizales, Colombia: A Times-Series Analysis 2008-2015.

OBJECTIVE: To identify seasonal and temporal variations in daily incidence of homicides and suicides in Cali and Manizales, Colombia during 2008-2015. MATERIALS AND METHODS: An ecological time series study was performed using negative binomial regression models for daily incidence of homicides and suicides; analyses were controlled for yearly trends and temporal autocorrelations. RESULTS: Saturdays, Sundays, December holidays as well as New Year and New Year's Eve were associated with an increased risk of homicides in both cities. Suicide risk increased during December holidays and New Year in both cities. In addition, the suicide risk increased on paydays, Saturdays, Sundays, and Mondays in Cali, and it decreased during the Holy Week holidays in Manizales. December patterns of suicides and homicides are the opposite in each city, and between cities. CONCLUSIONS: The incidences of homicides and suicides are not homogeneous over time. These patterns can be explained partially by alcohol consumption and changes in people's routine activities which may modify exposure to violent circumstances.

[System of comparable indicators for peaceful coexistence and citizen security: a consensus among countries]. / Sistema de indicadores comparables de convivencia y seguridad ciudadana: un consenso de países.

The Region of the Americas, with a homicide rate of 16.4 per 100,000 population (2004), is the second most violent region in the world, but public policy-making for the prevention of violence and crime is hampered by the absence of reliable and comparable data on the problem's various manifestations. This paper describes a 14-country initiative, sponsored by the Inter-American Development Bank in partnership with other regional agencies, to develop-collectively and by consensus- indicators for peaceful coexistence and citizen security that permit comparisons among countries, systematization of methods for the production and collection of pertinent data, the development of regional policies, and the dissemination and sharing of good practices. The selected indicators were homicide, death from road traffic injuries, suicide, death by firearm, sexual crime, family violence, child abuse, robbery, theft, vehicle theft and robbery, abduction, traffic offenses committed while under the influence of alcohol, general victimization, victimization by theft, victimization by robbery, perception of insecurity, perception of fear, confidence in institutions, and justification of the use of violence. For each indicator, agreement was reached on the type of measurement and the minimum variables that should be taken into account to have appropriate criteria for comparison.

Performance of a Likert adaptation of the SRQ-20 scale among women victims of intimate partner violence in Colombia: an exploratory study.

Women who are victims of intimate partner violence often suffer of depression and anxiety disorders. We evaluated the performance of the SRQ-20 scale (screening test for common mental health disorders), in women victims of intimate partner violence by male partners. A total of 100 women were surveyed from the out-patient mental health services in four health institutions in Valle del Cauca (Colombia). SRQ-20 scales (Binary version versus Likert version) were compared with mental health diagnoses based on the HSCL-25 scale, as the gold standard. Optimal SRQ-20 cut-off score is > = 6 points; lower than the initially suggested, sensitivity of 96.6% and specificity of 90.9%. The new SRQ-20-Likert scale, establishing a cut-off of > = 8 points, shows better sensitivity (98.9%) and equal specificity than the original scale. Studied SRQ-20 scales are promising instruments for screening mental health disorders among women victims of intimate partner violence in primary health care settings.

A qualitative study on factors associated with intimate partner violence in Colombia.

Intimate partner violence (IPV) is a human rights violation and a serious global public health problem. This study investigated factors associated with IPV in female survivors in Colombia. Four focus group discussions with female survivors of IPV and 15 key informant interviews with professionals from psychological, social and legal services and community leaders were conducted in Cali and Tuluá. Participant recruitment was via purposive sampling. Transcripts were analysed manually taking a social constructivist standpoint and a content analysis approach. Factors associated with IPV were divided into four themes: cultural beliefs, jealousy, alcohol abuse, and personal history of IPV. The first theme was divided into: patriarchy, gender roles, normalisation of violence, and unawareness of rights, economic dependence, and 'men own women'. The sub-themes were all inter-related and underpinned by patriarchal values. IPV was described as a sociocultural construction formed by patriarchal values ingrained in community and societal norms and individual processes. Therefore, academia, governmental and non-governmental bodies and society are urged to together, create preventative, context specific strategies for individuals, communities and societies.

Violence Exposure and Disability in Colombian Female Survivors of Intimate Partner Violence: the Mediating Role of Depressive Symptoms / Exposición a la violencia y discapacidad en mujeres colombianas sobrevivientes de violencia de pareja íntima: el papel mediador de los síntomas depresivos

ABSTRACT Background: Violence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability. Methods: This was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2. Results: The direct effect of IPV severity on the level of disability was not statistically significant ((3 = 0.09; P = 0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was ((3 = 0.39; P <0.01). The total effect of IPV severity on the level of disability was even greater ((3 = 0.48; P = 0.01). Conclusions: This study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

RESUMEN Introducción: La violencia es un importante problema de salud pública y una de las principales causas de muerte en todo el mundo. Las consecuencias para la salud mental de sobrevivir a la violencia de la pareja íntima incluyen depresión, ansiedad y trastorno de estrés postraumático. Estudios previos han identificado que existe una relación entre la depresión y el nivel de discapacidad en mujeres sobrevivientes a violencia de pareja íntima. La estimación del efecto directo, indirecto o total de una exposición en un resultado permite identificar efectos mediadores en un grupo de variables. La detección de los efectos de la mediación es útil para identificar vías causales que generan un resultado final y proporciona una justificación para diseñar intervenciones dirigidas al mediador, lo que a su vez afecta positivamente al resultado. El objetivo es identificar el efecto mediador de los síntomas de depresión en la relación entre gravedad de la violencia y el nivel de discapacidad de las mujeres víctimas de violencia de pareja. Métodos: Estudio transversal que incluyó a 94 mujeres de 18 o más años víctimas de violencia de pareja, identificadas en 2 instituciones públicas de salud de Cali y Tuluá, en el suroccidente de Colombia. Se realizó un análisis de rutas causales mediante un modelo de ecuaciones estructurales (SEM), en Stata® 14. Resultados: El efecto directo de la gravedad de la violencia en la discapacidad no es significativo ((3 = 0,09; p = 0,63); sin embargo, el efecto indirecto mediado por los síntomas de depresión incrementa su magnitud y es significativo (3 = 0,39; p <0,01). El efecto total es mayor y significativo (3 = 0,48; p = 0,01). Conclusiones: Existe un papel mediador de los síntomas depresivos entre la exposición a violencia de pareja y el nivel de discapacidad en las mujeres del suroccidente colombiano. Así, tratar los síntomas de depresión es fundamental para mejorar la funcionalidad de las mujeres víctimas de la violencia de pareja. Los resultados de esta investigación contribuyen a definir estrategias para prevenir y abordar la violencia de pareja, los síntomas depresivos y la discapacidad en esta población.

Impact evaluation of camera enforcement for traffic violations in Cali, Colombia, 2008-2014.

INTRODUCTION: Cameras for detecting traffic violations have been used as a measure to improve road safety in different countries around the world. In Cali, Colombia, fixed cameras were installed in March 2012 on a number of roads and intersections. All camera devices are capable of detecting simultaneously the following traffic violations: driving over the speed limit, running a red light or stop sign, violation of the traffic ban schedule, and blocking the pedestrian crosswalk. OBJECTIVE: To evaluate the impact of camera enforcement of traffic violations in Cali, Colombia. METHODS: A quasi-experimental difference-in-differences study with before and after measurements and a comparison group was conducted. We observed 38 intervention areas and 50 comparison areas (250 m radius), during 42 months before and 34 months after the installation of cameras. Effects were estimated with mixed negative binomial regression models. RESULTS: In intervention areas, after 12 months, there was a reduction of 19.2% of all crashes and a 24.7% reduction of injury and fatal crashes. In comparison areas, this reduction was 15.0% for all crashes and 20.1% for injury and fatal crashes. After adjusted comparisons, intervention sites outperformed comparison sites with an additional yearly reduction of 5.3% (p = 0.045) for all crashes. CONCLUSIONS: The use of cameras for detecting traffic violations seems to have a positive effect on the reduction of crashes in intervention areas. A beneficial spillover effect was found as well in comparison areas; but more evaluations are needed.

[Impact of interventions directed toward motorcyclist death prevention in Cali, Colombia: 1993-2001]. / Efectos de las intervenciones diseñadas para prevenir las muertes de motociclistas en Cali, Colombia (1993-2001).

OBJECTIVE: Describe the impact of interventions focused on decreasing deaths by motorcycle crash. MATERIAL AND METHODS: We analyzed variations in deaths by motorcycle crash in Cali when the interventions were implemented and the statistical significance of changes between 1993 and 2001. RESULTS: The rate of motorcyclist deaths per 100,000 inhabitants decreased from 9.7 in 1995 to 3.6 in 2001. The greatest reduction was observed after the introduction of the helmet law for motorcycle drivers in 1996 (12.3%). Other interventions-such as a helmet law for passengers, a reflective safety vest, a circulation ban for motorcyclists in December, and compulsory courses for all motorcyclists-produced a greater decrease in mortality; meanwhile, a lack of law enforcement increased it. CONCLUSIONS: The establishment and implementation of a combination of prevention strategies was more effective than a single or non-articulated strategy.

The evaluation of a surveillance system for violent and non-intentional injury mortality in Colombian cities.

Since 2002, the Institute for Peace Promotion and Injury/Violence Prevention (CISALVA) at the Universidad del Valle, Cali, Colombia and the Colombia Program at Georgetown University have developed and implemented 21 epidemiologically based municipal crime observatories in intermediate-sized municipalities in Colombia. These crime observatories serve as monitoring centres that provide low cost, geo-referenced methods of data collection and analysis, which allow cities to develop more responsive policies and prevention programmes and enhance governance. This article focuses on the methodology employed and lessons learned that may be applicable to similar settings. Worth noting within the results was a significant decrease in homicides after the first year of the programme. Whether or not such results could be attributed to the method or to the nature of the interventions and policy initiatives stemming from it remains open to conjecture.

Perceptions about implementation of a Narrative Community-based Group Therapy for Afro-Colombians victims of Violence.

Given the context and the number of armed conflict victims in the Colombian Pacific coast and their difficulties to access psycho-social care, Narrative Community-based Group Therapy appears as a viable mental health intervention. The objective of this study is to describe the process of implementation and results of the intervention in Afro-Colombian victims of violence, in the municipalities of Buenaventura and Quibdó. More specifically, we will be looking at the perspectives of workers and supervisors, through evaluative case studies and individual in-depth interviews. The therapy allows us to identify support and coping systems through coexistence, communication and interaction. It requires an adaptation process to the diversity of knowledge and expressions of victims of Colombian violence, greater empathy from care providers and rigor in their profiles selection, facilities ensuring security and confidentiality, and links with other educational, employment and recreational organizations. It is important to include these results while improving current and future intervention processes.

[Citizen security observatories: tools for decision making and governability]. / Observatorios de convivencia y seguridad ciudadana: herramientas para la toma de decisiones y gobernabilidad.

The need for good governability to promote countries development has been becoming the focus of governments. Latin America has political systems in crisis of governability caused by the inability of strategic actors to solve conflicts based on rules and procedures. The present review aims to describe how the creation of violence surveillance systems (observatories) contributes to strengthening governability and the creation of effective public policies. It was developed an analysis of the required components for the existence of governability and its relationship with the role of observatories in cities to provide reliable, timely and representative information that allows the formulation of strategies and policies. Governability is enriched with the legitimacy granted by the public from the results obtained by the governments in the formulation, implementation, evaluation of public policies and the evidence-based decisions in public health.

Common Elements Treatment Approach based on a Cognitive Behavioral Intervention: implementation in the Colombian Pacific.

Due to the limited supply of mental health services for Afro-Colombian victims of violence, a Common Elements Treatment Approach (CETA) intervention has been implemented in the Colombian Pacific. Given the importance of improvement in mental health interventions for this population, it is necessary to characterize this process. This article seeks to describe the implementation of CETA for Afro-Colombian victims of violence in Buenaventura and Quibdó, Colombia through case studieswith individual in-depth interviews with Lay Psychosocial Community Workers (LPCW), supervisors, and coordinators responsible for implementing CETA. From this six core categories were obtained: 1. Effect of armed conflict and poverty 2. Trauma severity 3. Perceived changes with CETA 4. Characteristics and LPCW's performance 5. Afro-Colombian culturalapproach and 6. Strategies to promote users' well-being.Colombian Pacific's scenario implies several factors, such as the active armed conflict, economic crisis, and lack of mental health care resources, affecting the implementation process and the intervention effects. This implies the need to establish and strengthen partnerships between institutions in order to administer necessary mental health care for victims of violence in the Colombian Pacific.

A qualitative study on factors associated with intimate partner violence in Colombia

Abstract Intimate partner violence (IPV) is a human rights violation and a serious global public health problem. This study investigated factors associated with IPV in female survivors in Colombia. Four focus group discussions with female survivors of IPV and 15 key informant interviews with professionals from psychological, social and legal services and community leaders were conducted in Cali and Tuluá. Participant recruitment was via purposive sampling. Transcripts were analysed manually taking a social constructivist standpoint and a content analysis approach. Factors associated with IPV were divided into four themes: cultural beliefs, jealousy, alcohol abuse, and personal history of IPV. The first theme was divided into: patriarchy, gender roles, normalisation of violence, and unawareness of rights, economic dependence, and 'men own women'. The sub-themes were all inter-related and underpinned by patriarchal values. IPV was described as a sociocultural construction formed by patriarchal values ingrained in community and societal norms and individual processes. Therefore, academia, governmental and non-governmental bodies and society are urged to together, create preventative, context specific strategies for individuals, communities and societies.

Resumo A violência por parceiro íntimo (VPI) é uma violação dos direitos humanos e um grave problema de saúde pública global. Este estudo investigou fatores associados à VPI em mulheres sobreviventes na Colômbia. Quatro discussões de grupos focais com mulheres sobreviventes de VPI e 15 entrevistas com informantes-chave com profissionais de serviços sócio-médico-legais foram realizadas usando amostragem intencional nas cidades de Cali e Tuluá. As transcrições foram analisadas manualmente, sob um ponto de vista construtivista social e uma abordagem de análise de conteúdo. Os fatores associados à VPI foram divididos em 4 temas: crenças culturais, ciúmes, abuso de álcool e história pessoal da VPI. O primeiro tema foi dividido em: patriarcado, papéis de gênero, normalização da violência, desconhecimento de direitos, dependência econômica e 'homens possuem mulheres'. VPI foi descrita como uma construção sociocultural formada por valores patriarcais e processos individuais. A VPI é causada por uma complexa interação de diferentes fatores nos níveis do indivíduo, relacionamentos, comunidade e social. Os órgãos governamentais e não governamentais e a sociedade são instados a criar juntos estratégias preventivas e específicas no contexto.

Trauma Registry of the Pan-American Trauma Society: One year of experience in two hospitals in southwest Colombia.

BACKGROUND: Trauma information systems are needed to improve decision making and to identify potential areas of intervention. OBJECTIVE: To describe the first year of experience with a trauma registry in two referral centers in southwest Colombia. METHODS: The study was performed in two referral centers in Cali. Patients with traumatic injuries seen between January 1 and December 31, 2012, were included. The collected information included demographics, mechanism of trauma, injury severity score (ISS), and mortality. A descriptive analysis was carried out. RESULTS: A total of 17,431 patients were registered, of which 67.8% were male with an average age of 30 (±20) years. Workplace injuries were the cause of emergency consultations in 28.2% of cases, and falls were the most common mechanism of trauma (37.3%). Patients with an ISS ≥15 were mostly found in the 18-35-year age range (6.4%). Most patients who suffered a gunshot wound presented an ISS ≥15. A total of 2.5% of all patients died, whereas the mortality rate was 54% among patients with an ISS ≥15 and a gunshot wound. CONCLUSION: Once the trauma registry was successfully implemented in two institutions in Cali, the primary causes of admission were identified as falls and workplace injuries. The most severely compromised patients were in the population range between 18 and 35 years of age. The highest mortality was caused by gunshot wounds. INTRODUCCIÓN: Los sistemas de información en trauma son requeridos para mejorar la toma de decisiones e identificar potenciales áreas de intervención. OBJETIVO: Describir el primer año de experiencia del registro de trauma en dos centros de referencia de trauma del suroccidente Colombiano. MÉTODOS: Estudio realizado en dos centros de referencia de Cali. Se incluyeron pacientes con trauma o lesiones externas entre el 1-Ene y el 31-Dic-2012. Se recolectó información demográfica, relacionada con mecanismos de trauma, severidad (ISS) y mortalidad. Se presenta un análisis descriptivo. RESULTADOS: Se registraron 17,431 pacientes. El 67.8% de los pacientes eran de género masculino con edad promedio de 30 (±20) años. Las lesiones laborales fueron causa de consulta a urgencias en un 28.2%, y las caídas el mecanismo de trauma más frecuente (37.3%). Los pacientes con ISS ≥15 en su mayoría se encontraban en el rango de edad de 18-35 años (6.4%). El 28% de los pacientes que sufrieron lesión por arma de fuego presentaron un ISS ≥15. El 2.5% de los pacientes murieron y aquellos pacientes con ISS ≥15 y lesión por arma de fuego presentaron mortalidad del 54%. CONCLUSIÓN: una vez se logró implementar el registro de trauma en dos instituciones en Cali, se identificó que la principal causa de ingreso fue secundaria a caídas y las lesiones laborales. Los pacientes más severamente comprometidos están en el rango de población entre 18 a 35 años. La mayor mortalidad se presentó secundario a lesiones de causa externa por arma de fuego.

The holistic transformative street-street gang intervention impact and its association with homicide rates in Cali, Colombia / El efecto holístico transformador de la intervención de las pandillas y su asociación con la tasa de homicidios en Cali, Colombia / O efeito transformador holístico da intervenção das gangues e sua associação com a taxa de homicídios em Cali, Colômbia

Abstract Cali is one of the cities in Colombia and Latin America with the highest rate of homicides, with around one third of homicides being attributed to street gang-related violence. In 2016, the Mayor's office from Santiago the Cali - Colombia, the Police Department and the Cisalva institute from Universidad del Valle worked together to develop an holistic intervention, "TIP -Youth without frontiers", to reduce street gang-related violence in Cali's communes. The intervention comprised six components focusing on developing personal/emotional skills, improving access to health and other public services, reducing substance use, connecting youth with employment and educational opportunities, promoting participation in sports and recreational activities, and improving the restitution of citizen rights to street gang members. This study aimed to describe the characteristics and implementation of this transformative street gang program and to describe changes in street gang-related homicides that could be associated with the implementation of this program. The program started contacting street gangs in January 2016, recruiting the first street gang members in August 2016. As of December 2018, 2.107 youth (from 84 Police identified street gangs) have participated in the program. A reduction in street gang-related homicides was observed in Cali's communes from 2015 to 2018. In intervened communes these homicides decreased on average by 80%, suggesting that the program could have contributed to the reduction of street gang-related violent behavior in these areas.

Resumen Cali es una de las ciudades de Colombia y de Latinoamérica con la tasa de homicidios más alta, con alrededor de un tercio de los homicidios atribuidos a la violencia entre pandillas. En 2016, la Alcaldía de Santiago de Cali - Colombia, la Policía Nacional y el Instituto Cisalva de la Universidad del Valle trabajaron juntos para desarrollar una intervención holística, "TIP - Jóvenes sin fronteras", con el fin de reducir la violencia relacionada con las pandillas en las comunas de Cali. La intervención abarcó seis componentes centrados en desarrollar habilidades personales/emocionales, mejorar el acceso a los servicios de salud y otros servicios públicos, reducir el consumo de sustancias, conectar a los jóvenes con oportunidades laborales y educativas, fomentar la participación en actividades deportivas y recreativas, y restituir los derechos cívicos a integrantes de las pandillas. El objetivo de este estudio era describir las características y la implementación de este programa de transformación de pandillas, y describir los cambios en la tasa de homicidios relacionados con pandillas que podrían estar asociados con la implementación de este programa. El programa comenzó contactando a las pandillas en enero del 2016, reclutando a los primeros miembros de estas en agosto del 2016. A diciembre del 2018, 2.107 jóvenes (de 84 pandillas identificadas por la policía) han participado en el programa. Se observó una reducción de los homicidios relacionados con pandillas en las comunas de Cali entre 2015 y 2018. En las comunas intervenidas, estos homicidios disminuyeron en promedio un 80%, lo que sugiere que el programa podría haber contribuido a la reducción del comportamiento violento relacionado con las pandillas en estas áreas.

Resumo Cali é uma das cidades da Colômbia e da América Latina com a maior taxa de homicídios, com cerca de um terço dos homicídios atribuídos à violência de gangues. Em 2016, a Prefeitura de Santiago de Cali - Colômbia, a Polícia Nacional e o Instituto Cisalva da Universidad del Valle trabalharam juntos para desenvolver uma intervenção holística, "TIP - Jovens sem fronteiras", a fim de reduzir a violência das gangues nas comunas de Cali. A intervenção abrangeu seis componentes focados no desenvolvimento de habilidades pessoais/emocionais, melhoria do acesso aos serviços de saúde e outros serviços públicos, redução do uso de substâncias, conexão dos jovens com oportunidades de emprego e educação, incentivo à participação em atividades esportivas e recreativas, e a restauração dos direitos cívicos para os membros das gangues. O objetivo deste estudo foi descrever as características e a implementação do programa de transformação de gangues e descrever as mudanças na taxa de homicídios por gangues que poderiam estar associadas à implementação deste programa. O programa começou contatando as gangues em janeiro de 2016 e foram recrutados os primeiros membros das gangues em agosto de 2016. Em dezembro de 2018, participaram do programa 2.107 jovens (de 84 gangues identificadas pela polícia). Uma redução dos homicídios relacionados a gangues nas comunas de Cali foi observada entre 2015 e 2018. Nas comunas intervencionadas, esses homicídios diminuíram em média 80%, sugerindo que o programa possa ter contribuído para a redução do comportamento violento relacionado a gangues nessas áreas.

[Risk Factors Associated With School Bullying in Local Authority Schools in Four Municipalities of Valle del Cauca, Colombia. Year 2009]. / Factores de riesgo asociados a la intimidación escolar en instituciones educativas públicas de cuatro municipios del departamento del Valle del Cauca. Año 2009.

OBJECTIVE: To determine the association between family and social relationships and School Bullying (SB) among peers in public education institutions in four municipalities of the department of Valle del Cauca, Colombia, during 2009. METHODS: A case-control study matched by sex and educational institution was carried out. The study population came from a secondary database provided by the Departof Health Secretaryhealth, which consisted of data gathered in a survey of schoolchildren enrolled in grades 6 to 11. The CISNEROS scale and the Family APGAR test were applied to measure outcome and exposure variables. A conditional logistic regression model was obtained to explain SB. RESULTS: It was found that schoolchildren living with a family where verbal and physical violence prevails, as well as in a hostile neighborhood, are more vulnerable to SB. The probability of being an SB victim is explained by: family dysfunction (OR=2.67; 95%CI, 1.05-6.82), verbal aggression at home (OR=2.81; 95%CI, 1.45-5.46), physical punishing parents (OR=2.53; 95%CI, 1.12-5.75), and neighbors who are physically aggressive to each other (OR=1.87; 95% CI, 1.00-3.56). CONCLUSIONS: The study confirmed that reported by Lopez, who suggested that victimization and school rejection in adolescence is related to factors outside the classroom, such as the quality of communication between parents and children. As regards family influence in the SB, Bowes indicates that a positive family atmosphere is significantly associated with the resilience of school victimization. Furthermore, being physically punished by parents generates low self-esteem in the schoolchild that leads to lack of self-protective attitudes to the attacks that occur within the school.

Perceptions about implementation of a Narrative Community-based Group Therapy for Afro-Colombians victims of Violence / Percepções sobre a implementação de uma Terapia Narrativa grupal baseada na Comunidade para afro-colômbianos vítima da Violência

Abstract Given the context and the number of armed conflict victims in the Colombian Pacific coast and their difficulties to access psycho-social care, Narrative Community-based Group Therapy appears as a viable mental health intervention. The objective of this study is to describe the process of implementation and results of the intervention in Afro-Colombian victims of violence, in the municipalities of Buenaventura and Quibdó. More specifically, we will be looking at the perspectives of workers and supervisors, through evaluative case studies and individual in-depth interviews. The therapy allows us to identify support and coping systems through coexistence, communication and interaction. It requires an adaptation process to the diversity of knowledge and expressions of victims of Colombian violence, greater empathy from care providers and rigor in their profiles selection, facilities ensuring security and confidentiality, and links with other educational, employment and recreational organizations. It is important to include these results while improving current and future intervention processes.

Resumo Dado o contexto e os números das vítimas de conflitos armado na costa do Pacífico da Colômbia, e as dificuldades de acesso aos cuidados psicossociais, a Terapia Narrativa de grupo Baseado na Comunidade aparece como uma intervenção de saúde mental viável. O objetivo do estudo é descrever o processo de implementação e os resultados da intervenção em vítimas afro-colombianas de violência, nos municípios de Buenaventura e Quibdó - Colômbia, a partir da perspectiva de trabalhadores e supervisores, através de estudos de avaliação e entrevistas em profundidade individuais. A terapia permite a identificação sistemas de apoio para o enfrentamento e o luto e através de convivência, comunicação e interação. Ele requer um processo de adaptação à diversidade necessária de conhecimento e expressões populares de vítimas da violência colombiana, maior empatia por parte dos prestadores de cuidados e rigor na seleção de seus perfis, instalações para garantir a segurança e confidencialidade, e links para outras organizações educacionais, trabalho e lazer. É importante incluir esses resultados na melhoria da intervenção processo atual e futuro.

Common Elements Treatment Approach based on a Cognitive Behavioral Intervention: implementation in the Colombian Pacific / Abordagem de Tratamento de Elementos Comuns com base em uma Terapia Cognitiva de Conduta: realização no Pacífico Colombiano

Abstract Due to the limited supply of mental health services for Afro-Colombian victims of violence, a Common Elements Treatment Approach (CETA) intervention has been implemented in the Colombian Pacific. Given the importance of improvement in mental health interventions for this population, it is necessary to characterize this process. This article seeks to describe the implementation of CETA for Afro-Colombian victims of violence in Buenaventura and Quibdó, Colombia through case studieswith individual in-depth interviews with Lay Psychosocial Community Workers (LPCW), supervisors, and coordinators responsible for implementing CETA. From this six core categories were obtained: 1. Effect of armed conflict and poverty 2. Trauma severity 3. Perceived changes with CETA 4. Characteristics and LPCW’s performance 5. Afro-Colombian culturalapproach and 6. Strategies to promote users’ well-being.Colombian Pacific’s scenario implies several factors, such as the active armed conflict, economic crisis, and lack of mental health care resources, affecting the implementation process and the intervention effects. This implies the need to establish and strengthen partnerships between institutions in order to administer necessary mental health care for victims of violence in the Colombian Pacific.

Resumo Devido à carência de serviços em saúde mental destinados aos Afro-colombianos vítimas de violência, a intervenção CETA (Common Elements Treatment Approach) foi implementada no pacífico da Colômbia. Dada a importância em melhorar essas intervenções, é necessário caracterizar o seu processo de execução. O objetivo deste artigo é descrever a realização da intervenção CETA para Afro-colombianos vítimas de violência em Buenaventura e Quibdó, Colômbia. Trata-se de estudo de caso com elaboração de entrevistas aprofundadas a Trabalhadores Comunitários Psicossociais (TCP), supervisores e coordenadores responsáveis pela execução CETA. Obtiveram-se seis categorias Núcleo: 1. Efeito do conflito armado e pobreza; 2. Severidade do trauma; 3. Mudanças percebidas com a intervenção CETA; 4. Características e desempenho dos TCP; 5. Enfoque na cultura Afro-colombiana; e 6. Estratégias para promover bem estar dos usuários. O contexto do pacífico colombiano está relacionado a múltiplos fatores, como o conflito armado ativo, crise econômica, e carência de serviços em saúde mental, afetando o processo de implementação e seus efeitos. Isto gera a necessidade de fortalecimento e estabelecimento de alianças institucionais, visando garantir a saúde mental das vítimas dessa região.

Observatorios de convivencia y seguridad ciudadana: herramientas para la toma de decisiones y gobernabilidad / Citizen security observatories: tools for decision making and governability

RESUMEN La necesidad de gobernabilidad para generar desarrollo en los países, se ha venido convirtiendo en foco de interés de los gobiernos. América Latina cuenta con sistemas políticos en crisis de gobernabilidad, dada la incapacidad de los actores estratégicos para resolver los conflictos basándose en reglas y procedimientos establecidos. La presente revisión tiene como objetivo mostrar cómo la creación de sistemas de vigilancia en violencia (observatorios) contribuye al fortalecimiento de la gobernabilidad y a la generación de políticas públicas efectivas. Se realizó un análisis de los componentes necesarios para la existencia de gobernabilidad y su relación con el papel que cumplen los observatorios para proporcionar información confiable, oportuna y representativa. La gobernabilidad se enriquece con la legitimidad otorgada por la ciudadanía a partir de los resultados de los gobiernos, en la formulación, implementación, evaluación de políticas públicas y la toma de decisiones en salud pública basadas en evidencia.

ABSTRACT The need for good governability to promote countries development has been becoming the focus of governments. Latin America has political systems in crisis of governability caused by the inability of strategic actors to solve conflicts based on rules and procedures. The present review aims to describe how the creation of violence surveillance systems (observatories) contributes to strengthening governability and the creation of effective public policies. It was developed an analysis of the required components for the existence of governability and its relationship with the role of observatories in cities to provide reliable, timely and representative information that allows the formulation of strategies and policies. Governability is enriched with the legitimacy granted by the public from the results obtained by the governments in the formulation, implementation, evaluation of public policies and the evidence-based decisions in public health.