Revista Facultad Nacional de Salud Pública

A guide for children and development that includes children and teenagers in their training. Review

Omar Segura — 2025-08-27

This review invites you to read and analyze a parenting guide for parents, a roadmap for children and adolescents, and an additional support for healthcare professionals and technicians who, out of necessity or desire, must accompany all of them from birth to the end of adolescence. A guide that offers a practical, accessible, and exciting approach to accompanying parents and caregivers on the journey through raising and ensuring the healthy and balanced development of their children, and that translates and transcribes into a simple format long hours of study and exhausting shifts by the co-authors, pediatricians, as well as sensibility and responsibility from motherhood.

Factors related to the consumption of sugar-sweetened beverages in children and adolescents in Colombia: A cross-sectional analysis

María Fernanda Acosta Romo — 2025-04-30

Objective: To determine the sociodemographic, economic, and behavioral factors related to sugar-sweetened beverage consumption in children aged 5 to 17 years in Colombia.
Methods: Cross-sectional study using the database of the 2022 National Quality of Life Survey carried out in Colombia. 55,396 records of children aged 5 to 17 were included; they were selected through probabilistic sampling. The relationship between the variables and sugar-sweetened beverage consumption was analyzed with Poisson regression models, sensitivity analysis, and multivariate regression models.
Results: The prevalence of sugar-sweetened beverage consumption is 75.86%. This consumption grows between 0.5% and 0.6% with increasing age (RPa = 1.005; 95% CI = 1.003–1.006). Packaged food intake raises sugar-sweetened beverage consumption between 52% and 57% (RPa = 1.55; 95% CI = 1.52–1.57). People living in the Central and Pacific regions consume less sugar-sweetened beverages, between 4% (RPa = 0.98; 95% CI = 0.96–1.00) and 6% (RPa = 0.97; 95% CI = 0.94–0.99), than those who live in the Orinoquia-Amazonia region.
Conclusion: The results highlight the importance of taking into account sociodemographic and behavioral characteristics when designing public health programs and policies, which is essential to counter the high prevalence of sugar-sweetened beverage consumption among children and adolescents in Colombia.

Obesidad y su asociación con el consumo de alimentos ultraprocesados en adultos mayores en Roraima, Brasil

Gabriela Rocha dos Santos — 2024-04-08

Objetivo: Estimar la prevalencia de la obesidad y analizar su asociación con el consumo de alimentos ultraprocesados (AUP) en adultos mayores en la atención primaria de salud.

Métodos: En este estudio transversal participaron 1322 adultos mayores de Roraima, Brasil. La obesidad se determinó mediante el índice de masa corporal, calculado a partir de mediciones de peso y altura. El consumo de AUP se evaluó con un formulario de marcador dietético utilizado a nivel nacional en la atención primaria. También se recopilaron datos sociodemográficos.

Resultados: La prevalencia de obesidad fue del 14%, y siete de cada diez adultos mayores reportaron haber consumido al menos un tipo de AUP el día anterior. Los adultos mayores que consumieron hamburguesas y carnes procesadas (aOR = 1,50; IC 95% = 1,08–2,08; p = 0,016) y aquellos que consumieron dulces y golosinas (aOR = 1,38; IC 95% = 1,02–1,80; p = 0,046) tuvieron mayor probabilidad de ser obesos en comparación con aquellos que no consumieron AUP.

Conclusión: Aunque la obesidad afecta a una parte significativa de los adultos mayores, el consumo de AUP es frecuente entre ellos. Reducir el consumo de AUP, especialmente hamburguesas, carnes procesadas, dulces y golosinas, es esencial para promover la longevidad y la calidad de vida en la vejez.

Protocolo de estudio para una encuesta sobre la epidemiología de la hipertensión en Tetuán, Marruecos, empleando el método de muestreo por conglomerados estratificados

Safae El Haddaoui — 2025-08-01

Objectivo: Este artículo presenta el diseño y el marco metodológico de un protocolo de una encuesta transversal de base poblacional, destinada a evaluar la prevalencia, el conocimiento, el tratamiento y el control de la hipertensión en Tetuán, Marruecos.

Métodos: Se adoptó un diseño transversal. El estudio utilizó un proceso de muestreo por conglomerados estratificado multi etapas, que requirió especial atención para minimizar posibles sesgos y garantizar una recolección de datos eficiente.

Resultados: El artículo proporciona una descripción detallada de cada fase del proceso de la encuesta, comenzando con la planificación inicial, pasando por las etapas de muestreo y las mediciones físicas realizadas, y concluye con los métodos estadísticos para el análisis de datos. La metodología del estudio se diseñó para proporcionar datos fiables y actuales sobre la epidemiología de la hipertensión en la región.

Conclusión: Esta investigación contribuye con información valiosa para quienes planifican o realizan encuestas poblacionales similares.

Participatory and governance processes in food sovereignty and security during the COVID-19 pandemic in Commune 1 of Medellín, 2021

Lorena Patricia Mancilla-López — 2025-08-01

Objective: To understand the participatory and governance processes surrounding food sovereignty and security that developed in the context of the COVID-19 pandemic in Commune 1 of the Popular District of Medellín, Colombia.

Methods: The study was participatory action research, through a dialogue of knowledge. A strategy aimed at community training and participation was developed, called the “School of Leaders and Managers of Food and Nutrition Sovereignty and Security”, comprised mostly of women. Grounded theory was used to analyze the qualitative data collected through 15 individual and 20 group interviews. The research process was carried out during 2021.

Results: Four phenomena were identified in this training and knowledge-sharing space: the first is the worsening of food insecurity in commune 1 due to the COVID-19 pandemic and the strategies to address it from predominantly welfare-based approaches, which have little impact on the social, economic, and cultural determinants necessary to guarantee the right to healthy food; the second is the inefficiency of institutional management in the face of the social needs of commune 1, which is immersed in a scenario of exclusion and failures to guarantee rights; The third outcome is the implementation of plans, programs, and projects that do not correspond to the territorial dynamics in which the problems manifest themselves. Finally, the influence of economic, social, and cultural determinants that influence the environment and limit the guarantee of the human right to food for the population of Commune 1 is evident.

Conclusion: It was recognized that community-based forms of organization represented the main mechanism for preventing the worsening of the food crisis resulting from the COVID-19 pandemic. Therefore, they represent a potential for addressing temporary and structural social and food crises.

Prostate cancer and screening tests: experiences and sociocultural beliefs of rural adults

Isabel Cristina Flórez-Escobar — 2025-07-23

Objective: To understand the experiences and sociocultural beliefs of rural adults about prostate cancer and screening tests.

Methods: Qualitative study with a focused ethnographic design. The sample was made up of men over 50 years of age, from La Playa village of the municipality of Caldas (Boyacá, Colombia) for the year 2023. The information was collected through in-depth interviews.

Results: Three categories were obtained: experiences and knowledge about prostate cancer and screening tests; sociocultural beliefs about prostate cancer and screening tests; and access barriers to prostate cancer screening. Perception of cancer risk and the importance of screening tests are influenced by previous experiences and sociocultural factors. In addition, barriers such as limited access to medical services, as well as economic and geographic difficulties, complicate testing and follow-up.

Conclusions: Understanding of prostate cancer is conditioned by personal and family history. Although some people recognize certain risk factors, there is still a notable lack of knowledge about screening tests and symptoms of the disease, which complicates early detection. The prostate-specific antigen (PSA) test is the most widely accepted test among men, and knowing of someone close with prostate cancer often encourages screening. However, significant barriers to access persist, especially due to lack of information about available health services and tests.

Evidence of validity and reliability of the Climate and Health Tool (CHANT): Spanish language version adapted to tropical Latin America

Ericka Carolina Murillo-Rodríguez — 2025-08-27

Objective: To culturally adapt and evaluate the internal structure (evidence of construct validity and internal consistency) of the CHANT scale in spanish, adapted to tropical Latin America, with health professionals from Costa Rica.

Methods: The study was observational and instrumental. The psychometric characteristics of validity (content and construct validity) and reliability of the instrument in Spanish in Costa Rica were analyzed. Data were collected from surveys of 229 health professionals, using snowball sampling stratified by regions of the territory. R-Studio software was used to determine Cronbach's alpha and confirmatory factor analysis.

Results: The internal consistency reliability, assessed by Cronbach's alpha, was 0.88. The five-subscale model was validated by confirmatory factor analysis goodness-of-fit tests (n = 229, Comparative fit index = 0.93; Mean square error = 0.06, Standardized mean square residual = 0.06; Normalized parsimony fit index = 0.74).

Conclusion: The Spanish language version of the T-CHANT shows evidence of construct validity and satisfactory reliability for measuring health professionals' awareness, motivation, concern, and behaviors at work and at home in relation to climate change and health.

Comment on “Association between oral cancer mortality and public health expenditure in Colombia between 2012 and 2022: an ecological study”

Jose Montano-Caicedo — 2025-10-20

Fluorosis dental y factores asociados en escolares colombianos: un estudio de métodos mixtos

Bruno Gutiérrez-Quiceno — 2025-06-09

Objetivo: Identificar la prevalencia y los factores asociados con la fluorosis dental (FD) en escolares y comprender la percepción y el conocimiento de los padres/tutores sobre esta condición.

Métodos: En este estudio de métodos mixtos, los investigadores realizaron exámenes clínicos a escolares, así como encuestas y entrevistas semiestructuradas con padres/tutores en Nariño, Colombia, durante 2023. Los investigadores analizaron los datos mediante estadística descriptiva y análisis multivariado (cuantitativo), con la variable dependiente fluorosis medida mediante el índice de Dean. Los datos se categorizaron según el análisis de contenido (cualitativo). El análisis de narrativas y la triangulación de los hallazgos se basaron en los principios de la teoría fundamentada.

Resultados: Utilizando el índice de Dean, el modelo ajustado encontró que la prevalencia de fluorosis aumentó con la edad entre individuos con niveles “muy leves” versus “leves” (RDa = 1,85; IC 95% = 1,24-2,75) o en hombres (RDa = 3,08; IC 95% = 1,06-8,90), y fue menor en aquellos individuos que vivían en áreas urbanas (RDa 0,21; IC 95% = 0,06-0,71) o entre sujetos que tenían un chequeo dental tres o más veces al año (RDa = 0,12; IC 95% = 0,02-0,83). La prevalencia también aumentó con la edad en individuos con niveles muy leves versus moderados (RDa = 2,21; IC 95% = 1,10-4,42) o en aquellos cuyos padres reportaron saber sobre la fluorosis (RDa = 35,58; IC 95% = 3,50-361,14) y fue menor en individuos que consumían la marca de sal más popular en el área (RDa = 0,41; IC 95% = 0,002-0,90). Diez individuos participaron en la entrevista semiestructurada; se observó una falta de conocimiento sobre la fluorosis dental y los participantes la percibieron como un proceso natural o de fortalecimiento de los dientes. A través de la triangulación, se identificó la edad como un factor que interactúa con la fluorosis.

Conclusión: Los hallazgos de este estudio sugieren que la frecuencia de los controles dentales, la edad, el sexo, el lugar de residencia, el conocimiento y la percepción de los padres / tutores y la dieta se asociaron con la presencia de fluororis dental.

Association between oral cancer mortality and public health expenditure in Colombia between 2012 and 2022: an ecological study

Brenda Yuliana Herrera Serna — 2025-04-30

Objective: To analyze the association between oral cancer mortality and public health expenditure in Colombia between 2012 and 2022.
Methods: An ecological study was conducted, analyzing age-adjusted mortality trends per 100,000 inhabitants. The association was explored using a multilevel model that incorporated per capita public health expenditure, year, and department as covariates.
Results: Per capita public health expenditure had a median of $26,279, a minimum of $9,576, and a maximum of $589,278. Nationally, the mortality rate for 2022 for men was 2.42 (95% CI: 2.21–2.63), and for women, 1.66 (95% CI: 1.49–1.84). The departments with the highest mortality rates for men were Santander, Tolima, and Meta; for women, Santander, Risaralda, and Bogotá. Increasing trends were observed for both sexes. The multilevel model showed an increasing mortality rate, with a mean per capita expenditure of 0.042 per million (95% CI: 0.000019–0.93; p = 0.04).
Conclusions: A positive association was observed between public health expenditure and mortality. In addition, an increasing rate of mortality from oral cancer was observed in Colombia.

Factors associated with cigarette smoking in a Peruvian district of high socioeconomic level

Alberto Guevara-Tirado — 2025-03-10

Objective: To identify and classify the socioeconomic factors associated with cigarette smoking in a Peruvian district of high socioeconomic level.
Methods: Cohort study using data from the "Census of Health and Determinants of the District of San Borja" from 2021 to 2022, with 49,082 respondents. The total database was studied, which responded to the question of whether they had smoked cigarettes in the last 12 months. Variables such as cigarette consumption, sex, age, educational level, marital status, work activity, and others were analyzed. Binary logistic regression and chi-squared automatic interaction detection (CHAID) decision tree analyses were applied.
Results: The percentage of smokers was 3.70%. Single adults were 1.46 times more likely to smoke. Those living in shared apartments were 1.38 times more likely to smoke, while people without their own housing were 2.01 times more likely to smoke. Men were 2.574 times more likely to smoke than women. The CHAID decision tree showed that, for males, job instability is a main factor, while for women the economic crisis and criminal acts in the home were key factors.
Conclusions: Job instability and precarious living conditions are associated with cigarette smoking in men and women, respectively. The main socioeconomic profile of cigarette users was being male, not owning a house and being single.

Assessment of long-term exposure to fine particulate matter (PM2.5) in MEDELLIN cohort study.

Juan Gabriel Piñeros-Jiménez — 2025-03-10

Objective: to evaluate the variability of pm2.5 during the period 2018-2019 in the urban area of Medellín at different geographic scales.

Methods: the land use regression (lur) model was applied, considering as dependent variable the mean annual concentration of pm2.5 of Medellin and nearby monitoring stations, buffers were defined with radii of 100, 150, 200, 300 and 500 m and center in the coordinates of the monitoring sites of the dependent variable, with each buffer a model was built.

Results: The selected models for the years 2018 and 2019 explain between 40 and 46% of the variability of pm2.5 with errors of the predicted concentrations of 1.64 µg/m3 and 2.18 µg/m3, respectively. The distribution of air pollutant was heterogeneous at neighborhood and block level, with the highest annual concentrations located towards the central strip of the city in the areas surrounding the Medellin River with marked areas towards the south and center. While for 2018, concentrations above 15 µg/m3 were estimated in 21% of the blocks, for 2019 100% of the estimates were above this concentration.

Conclusions: lur models were developed to assess pm2.5 exposure at different spatial scales in which land use and traffic explanatory variables predominated. Exposure levels below 25 µg/m3 were estimated at the different scales, a low variability that allowed the assignment of individual long-term exposures by place of residence in the participants of the medellín cohort project.

Prevalence of obstructive sleep apnea in patients with arterial hypertension

Franklin Escobar-Córdoba — 2024-12-20

Objective: To estimate the prevalence of obstructive sleep apnea in patients diagnosed with arterial hypertension.

Methods: Cross-sectional study in 449 patients diagnosed with arterial hypertension from the Chronic Patients Care and Follow-up Program of the State Social Enterprise Hospital of El Tambo, Cauca. The Epworth sleepiness scale and the STOP-bang test, previously validated, were administered.

Results: The study population had a mean age of 67 years, with 67.3% being women. The mean body mass index was 26.8, the mean neck circumference was 36 cm, the mean waist circumference was 96 cm, and 23.6% had moderate daytime sleepiness, while 5.3% had severe sleepiness. The mean number of antihypertensive medications used was 2, and 7.1% had uncontrolled hypertension. A STOP-bang test score of 3 or higher was found in 32.8% of participants. The STOP-bang test was positive for obstructive sleep apnea in subjects with uncontrolled blood pressure (p = 0.006); body mass index greater than 35 kg/m2 (p = 0.035), number of antihypertensive medications (p = 0.004) and abdominal circumference (p = 0.007). In the generalized linear model analysis, the adjusted prevalence ratio was calculated and revealed moderate sleepiness. Being a man older than 50 years, having a larger neck circumference and abdominal circumference, and age are important associated risk factors for uncontrolled hypertension.

Conclusions: A prevalence of obstructive sleep apnea of 32.8% was found in hypertensive patients, a figure higher than that of the general population.

Spatiotemporal variations in COVID-19 mortality during the four waves of spread in Argentina, 2020-2022

Carlos Marcelo Leveau — 2024-12-20

Objective: To analyze the emergence of spatiotemporal clusters of COVID-19 mortality, during the four waves of spread in Argentina, between 2020 and 2022, characterizing them by their level of population density and socioeconomic level.

Methods: Retrospective ecological study design applied to deaths from COVID-19, in populations under 60 years of age and 60 years of age or older, occurring in Argentina from 2020 to 2022. The spatial units (n = 527) were departments or similar areas. The spatiotemporal permutation scanning technique was used to detect high and low mortality clusters. These were compared with each other in terms of population density level and socioeconomic level.

Results: In the population under 60 years of age, there was hierarchical diffusion, affecting Greater Buenos Aires, in the first wave, while, in the third, high mortality clusters tended to be located in areas of low socioeconomic level. In the population aged 60 or older, there were hierarchical mortality diffusions in the first, third and fourth waves. With the exception of the second and third waves, high mortality clusters tended to be located in areas of high socioeconomic level, compared to low mortality clusters

Conclusion: Although Greater Buenos Aires-La Plata —the most populated area in the country— was the hardest hit in terms of mortality in both the first and third waves, the spatiotemporal heterogeneity of the clusters detected in the four waves suggests the reinforcement of the geographical representativeness of virological and epidemiological surveillance in the Argentine territory.

Prevalence of negative attitude towards COVID-19 vaccines and its association with institutional trust and infodemic in the adult population of the department of Magdalena

Carmen Cecilia Caballero — 2024-11-21

Objective: To determine the prevalence of attitudes towards the COVID-19 vaccine and its association with institutional trust and infodemic in Colombian adults.

Methodology: An analytical cross-sectional study was designed, with the participation of adults living in Colombia, who answered the Trust in the institutional response to the outbreak scale (Trust in the institutional response to the outbreak), the Resistance Scale or attitude towards the vaccine and the infodemic questionnaire.

Results: A total of 1,441 participants aged 18 to 74 years (M=22.28; SD=6.65). 55.93% were female and 66.97% had a university education, and 68.49% reported low income. The prevalence of resistance to the COVID-19 vaccine was 63.98%. Negative attitude toward the vaccine associated with low trust in institutions during outbreaks (aOR=1.80; 95% CI 1.45-2.25), and an infodemic evidenced in the misinformation that getting vaccinated for COVID-19 can have side effects (aOR=1.5; 95% CI 1.12-2.09) and implant a microchip (aOR=1.52; 95% CI 1.20-1.94). The variables emerging age, wage income, and vaccine limitation of civil rights were not linked to negative attitude toward the vaccine.

Conclusion: The prevalence of negative attitude towards the COVID-19 vaccine was 63.98% and was associated with low trust in institutions during outbreaks and an infodemic evidenced by misinformation and concern about the side effects of the vaccine and will implement a microchip when vaccinated. Future research requires longitudinal studies of attitudes during the post-pandemic.

Escaleras

Juan Fernando Ospina — 2025-02-24

Adaptation and validation of IN-PATSAT32 questionnaire in home oncology palliative care users

Daniela Barriga-Bustos — 2025-04-29

Objective: To adapt and validate the content and reliability in the Chilean population of the IN-PATSAT32 questionnaire for users of the Palliative Care Program in home care, evaluating the psychometric characteristics of the scale.

Methods: Content validation study consisting of expert evaluation and analysis of the internal consistency and construct validity of the instrument IN-PATSAT32 with cancer for users in palliative care, Chilean version through exploratory factor analysis.

Results: The reliability analysis of the test demonstrated good performance with a value of α = 0.97 on the overall scale, and an alpha greater than 0.96 for each item analyzed separately. Concerning the factorial structure of the instrument, a confirmatory factor analysis was conducted using the Kaiser-Meyer-Olkin measure of sampling adequacy (KMO = 0.76) and Bartlett’s test of sphericity, which was statistically significant (χ² = 32.49; p = 0.00).

Conclusion: The reliability and construct validity of the instrument are comparable to those found in other studies, demonstrating its adequate properties and effectiveness in a different cultural environment. The questionnaire proved reliable for use in a population of oncological palliative care users at home. The questionnaire is proposed as an evaluation tool for work with oncological palliative care users at home to measure and enhance satisfaction levels.

Development of an instrument for the measurement of patients’ perception of care integration within the cardio-cerebrovascular services pathway

Sandra Marcela Camacho-Rojas — 2025-03-11

Objective: To develop an instrument to measure patient perceptions about integrated care in the cardio-cerebrovascular care pathway.
Methods: An instrument was designed after carrying out a systematic search and a free search in the literature to identify scales and surveys measuring patient perceptions about integrated health care. We selected items evaluating the construct of integration, applicable to the Colombian context and useful for quality improvement actions; and subsequently, an instrument was developed. An expert panel assessed the first version to analyze the validity of its contents. Some adjustments were made and a pilot test was carried out with 14 patients in order to assess the clarity and suitability of the items.
Results: The initial instrument included 18 items from 7 surveys and 10 new items developed by the researchers. The experts confirmed the validity of the instrument and suggested adjustments to the wording and response options to adapt it to the local context. The pilot test led to minor changes in the explanations and wording in response options. The final instrument included 28 Likert-type items.
Conclusion: An instrument was developed according to the international literature and adapted to the local context in order to measure patient perception about integrated care in the cardio-cerebrovascular care pathway.

Effectiveness of the 6-minute walk test in the assessment of aerobic capacity in people with obesity: a scoping review

Nathali Carvajal-Tello — 2025-03-28

Objective: This scoping review aimed to systematize the available evidence on the effectiveness of the 6-minute walk test in the assessment of aerobic capacity in people with obesity, and its usefulness for the prescription of physical exercise.

Methods: PubMed, Science Direct, Springer, Scopus and LILACS databases were reviewed. The search was limited from 2013 to 2023. Randomized controlled studies and prospective longitudinal studies were included. The data obtained were analyzed using the checklist proposed by the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Results: A total of 10 papers reporting results from randomized controlled studies and prospective longitudinal studies (50% of each) were analyzed, with 70% being from the Americas and 90% being written in English. The total number of participants was 1,575, and they were aged between 18 and 75 years. In the studies that specified sex, 66.3% were women. The body mass index for the experimental group ranged from 30.5 ± 2.8 to 48.99 ± 11.61 kg/m2. The distance traveled in the 6-minute walk test was observed to range from 428.3 ± 85.7 m, p < 0.0001, to 602.6 ± 70.2 m, p = 0.001. The VO2 max ranged between 16.9 ± 2.7 mLO2/kg/min-1 (p < 0.05) and 25.1 ± 4.7 mLO2/kg/min-1 (p = 0.001).

Conclusion: The 6-minute walk test is an effective and complementary tool in the design of exercise programs aimed at people with obesity, as it is a useful, simple and objective measure for exercise prescription and clinical follow-up.

Patterns of alleged sexual violence assessed in health services in five municipalities of Southwestern Colombia. 2014-2016

Mercedes Salcedo-Cifuentes — 2025-02-10

Objective: Establish the patterns of alleged sexual violence in people who consulted the health services of five municipalities in the Colombian Southwest between 2014-2016.

Method: This is a descriptive study with multivariate exploratory analysis that was used as a source of information on the care records of the emergency department of five hospitals of medium and low complexity in southwestern Colombia. Individual and relational variables of the event were considered. The XLSTAT statistical package is used.

Results: Were identified four patterns of alleged sexual violence: intrafamilial, extrafamilial and combinations between these, differentiated by the sociodemographic characteristics of the victim, the relationship with the aggressor, and the contextual characteristics of the town where the event occurred.

Conclusions: The findings make it clear that the vulnerable groups are children and young women from low socioeconomic strata. This crime is committed within the family nucleus, and several of the patterns are consistent with the social characteristics of the municipalities where the event occurs.

Health-promoting school in México, after 20 years of implementation

Tonatiuh Cabrera Franco — 2025-10-20

One of the core components of the global health promotion project has been the development of so-called “healthy spaces”, which aim to create physical and social environments that foster health. A key initiative within this framework has been the health promoting schools, which have been promoted globally since 1995, although a clear definition of the concept was not established until 2022. Over the past 30 years, the program has been implemented in various parts of the world in diverse ways and with heterogeneous results, yet little attention has been given to analyzing what has actually been understood by them. In order to contribute to the debate on how has been interpreted this paper identifies the main criteria that have structured the implementation of the program in Mexico over 20 years, based on four general pillars that have been adapted and refined over time, establishing a specific and concrete understanding of what it means to be an Health Promoting School in a diverse and multicultural country.

Beyond and from the hospital: a critical and courageous science to transform health together with the people

Jaime Breilh — 2025-04-08

Voices against famine in the Gaza Strip

Alex De Waal — 2024-08-13

Genocide: a word carved in absence

Xabier Irujo — 2025-06-24

Public health surveillance in the first quarter of the 21st century and the challenges for the next quarter

Franklin Prieto-Alvarado — 2025-04-29

The World Health Organization and the challenges of global health

Álvaro Franco-Giraldo — 2024-03-31

Armed conflict in Colombia and the challenges of public health within the context of “Total Peace”

César García-Balaguera — 2024-12-16

Education and public health for peace

Gabriel Vélez — 2024-12-18

Gynecological violence in the Chilean health care system: a comparison between migrant and Chilean women

María Rocío Menanteux-Suazo — 2025-08-01

Objective: To compare the levels of gynecological violence reported by migrant and Chilean women in the Chilean health system.

Methods: Cross-sectional descriptive study, based on secondary analysis of data from 102 migrant and 94 Chilean women, obtained from the "First national survey on gynecological and obstetric violence" (2019).

Results: The mean age was 31 years (standard deviation 12.86); 52% of the participants were migrants and 48% were Chilean. The educational level was high: 53% had university studies and 22% had postgraduate studies. There were differences in terms of access to and coverage by the health care system. Sixty-six percent of Chilean women used the National Health Fund, compared to 44.7% of Latin American migrants and 40.9% of non-Latin American migrants who also used it. Latin American migrants had a higher identification with native peoples (16.4%) and Afro-descendants (16.4%), compared to Chilean women and European or U.S. migrants. Significant differences were found in the dimensions of psychological and physical violence, with Latin American women reporting higher levels of gynecological violence compared to Chilean women and migrants from Europe and the United States.

Conclusion: The findings show intersectional dynamics of violence and discrimination in gynecological care in Chile, which affect women differently according to national origin. The urgency of addressing structural inequalities in the health care system is highlighted, to ensure equitable and respectful care for all women.

Quality of health care with a gender focus in MujerESalud, the comprehensive health care strategy in Bogotá

Salomé Valencia Aguirre — 2024-12-12

Objective: To identify the perceptions that health personnel and women users have about the quality of health care with a gender focus in the “Comprehensive Health Care Services” (MujerESalud) strategy, implemented by the District Health Secretariat of Bogotá in 2023, to provide comprehensive health care to women in the city, within the framework of the initiatives, policies and programs derived from the District Development Plan 2020-2024 “A new social and environmental contract for Bogotá in the 21st century”.

Methods: A qualitative study was carried out, with a phenomenological design, descriptive and narrative scope. 44 people were interviewed, including managers, health personnel and users of nine care centers in Bogotá where the strategy was implemented.

Results: The experience was positive for the women users, as well as for the staff linked to the strategy. However, some opportunities for improvement and barriers that must be eliminated to guarantee better quality and access to health services for women in the capital were also identified.

Conclusion: The MujerESalud strategy managed to improve the quality of care with a gender focus among the beneficiaries, by assigning appointments for general medicine and nursing in less than three days and training health personnel in care with a gender focus. It also managed to articulate with the service offering of the Manzanas del Cuidado. However, future experiences require expanding the service offering, to achieve comprehensive, timely and decisive health care for women.

Blanca Varela (Lima, 1926 – 2009)

2025-02-24

Profile of psychoactive substance consumption associated with risk levels of suicidal behavior in Argentine adolescents

Alberto Guevara-Tirado — 2025-03-11

Objective: To identify the characteristics of psychoactive substance use associated with risk levels of suicidal behavior in Argentine adolescents.

Methods: Study based on the Argentine School Health Survey of 2018 as a secondary source, whose probabilistic sampling consisted of 56,981 schoolchildren aged 13 to 17 years. The 3 levels of suicidal behavior were analyzed (ideation, planning and attempt). The classification tree using automatic detection of chi-square interactions, the crude and adjusted Odds Ratio (OR) using binary logistic regression, sensitivity, specificity, and positive and negative predictive value were used.

Results: The overall frequency of suicidal ideation in the past 12 months was 21.50% (n = 11,962), while 17.30% (n = 9,734) had suicidal planning and 15.10% (n = 8,507) attempted suicide at least once during the same period. For suicidal ideation, planning and attempt, the most common profile of association was a history of cigarette smoking, amphetamine/methamphetamine use and drinking alcohol alone. Based on this profile, it was observed that for suicidal ideation, adolescents had an adjusted OR of 8.10 (95% CI = 5.22-10.55). The specificity was 99.11%; the positive predictive value was 63%; and the negative predictive value was 80%. For suicidal planning, adolescents had an adjusted OR of 7.13 (95% CI = 4.70-9.84). Specificity was 99.10%, with a positive predictive value of 60% and a negative predictive value of 83%. For suicide attempt, adolescents had an adjusted OR of 8.14 (95% CI = 5.69-10.64). Specificity was 99.80%, with positive and negative predictive values of 62% and 85%, respectively.

Conclusions: This research provides evidence of the strong association between solitary alcohol consumption, amphetamine/methamphetamine use, and smoking with suicidal behavior in Argentine adolescents. ¿Furthermore, smoking predisposes adolescents to the use of psychostimulants. The importance of developing preventive strategies and public policies to reduce this behavior in adolescents is highlighted.

Work practices associated with silica and asbestos exposure in the Colombian construction sector, 2024

Eliana Milena Téllez Avila — 2025-09-22

Objective: To identify work practices associated with silica and asbestos exposure in the Colombian construction sector.

Methodology: A qualitative study of exploratory scope was carried out in 9 companies that met the criteria for safety, occupational health and environmental protection, classified as high performance, with scores equal to or above the median (88/100 points). The study population were workers and leaders of the occupational safety and health management system. Twenty-nine semi-structured interviews were conducted between January and November 2024. The data analysis had a categorical thematic approach, with three categories defined based on Resolution 0312 of 2019 of the Colombian Ministry of Labor: 1) guidelines, 2) process and risk management, and 3) capacity building and culture.

Results: The practices identified were Category 1: lack of knowledge and limited implementation of regulations, absence of specific policies for silica and asbestos. Category 2: general hazard matrices that do not include these substances, basic control measures and epidemiological surveillance systems without integration of silica- and asbestos-related diseases. Category 3: empirical learning, general training,s and self-care culture.

Conclusions: Gaps in compliance with legal requirements and management practices for silica and asbestos exposure were evidenced, despite being companies classified as high performance. This indicates a need to strengthen risk management, regulatory compliance and practices regarding exposure to these substances in the construction sector in Colombia.

Occupational risks perceived by rural workers in panela production in the municipality of Nariño, Antioquia

Yeymy Cardona-Echeverri — 2025-06-30

Objective: To understand the occupational risks perceived by rural workers in panela production in the municipality of Nariño, Antioquia.

Methods: Descriptive study with a qualitative approach based on the theoretical concepts of Blumer's symbolic interactionism; the research method and design follow Corbin and Strauss' grounded theory; and the Colombian Technical Guide 45 of Icontec was used for hazard classification. Convenience and snowball sampling were used, until theoretical sampling was reached, with 13 participants. The information collected through interviews, observation and photovoice exercises was transcribed and analyzed by applying open, axial and selective coding; then, from the descriptive, analytical, and interpretative categories that were generated a substantive theory was developed. The duration of the study was nine months, between December 2021 and September 2022.

Results: The people who work in panela production do perceive and recognize the risks to which they are exposed in their work. However, panela producers face such risks because of the economic income received and the need for subsistence. Moreover, women work both directly in the mill and indirectly in household chores and food preparation for their family and mill operators, which increases their workload.

Conclusion: There is a relationship between panela production work, even with exposure to high occupational risks, and the economic income obtained for livelihood, as well as with a greater workload for women. From an occupational health and safety perspective, a reflection on the relationship between the execution of risky work activities and the monetary income received is required in order to propose the adoption of preventive measures.

Protective and risk factors for suicidal ideation in public hospital workers in Chile: organizational dimensions and destructive leadership

Elisa Ansoleaga Moreno — 2025-05-30

Objective: To identify protective and risk factors in the relationship between destructive leadership, organizational dimensions, and suicidal ideation in public health workers in Chile.

Methods: A cross-sectional study. A survey was administered to 1,855 public hospital workers from three regions in Chile between January and May 2023. Sampling was probabilistic, stratified by sex and professional category. Using logistic regression models segmented by sex, the association between leadership styles (laissez-faire, tyrannical, and constructive), mental health (suicidal ideation), and organizational dimensions (work harassment, emotional demands, role conflict, work vulnerability, conflict management climate) was analyzed.

Results: 6.42% of the sample presented suicidal ideation; 32.94% reported laissez-faire leadership; 13.42%, tyrannical leadership; and 85.93%, constructive leadership. The adjusted models showed us that men exposed to laissez-faire leadership [ORa = 2.52 (95 % CI: 1.34-5.76)] and tyrannical leadership [ORa = 2.80 (95 % CI: 1.33-5.87)] are almost three times more likely to present suicidal ideation than those not exposed. A favorable conflict management climate is a protective factor for suicidal ideation for the total sample of workers [ORa = 0.58 (95 % CI: 0.34-0.98)].

Conclusion: Destructive leadership is a risk factor for suicidal ideation in men. Work harassment and emotional demands also act as risk factors for suicidal ideation in men and women, and work vulnerability is a risk factor only in women. A favorable conflict management climate constitutes a protective factor for mental health in organizations and a possible avenue for intervention.