Abstract This article shows the results of the study “Virtual Office of 10,000 sustainable peasant farms from the regions of Santander and Magdalena Medio”. The study is framed in a Colombian social movement for the preservation of the peasant farm as pivotal axis for food sustainability in the territories. The study has a principal aim to identify the organization process of fourteen (14) food communities and the participatory design of the peasant farm model as strategies for food security in the Colombian territories of Magdalena Medio and Santander. The study conducted a mixed methodology with both qualitative and descriptive, cross-sectional quantitative analysis with data collected from participant communities. Data collection was done through focus groups with seven (7) communities and fourteen (14) interviews with food community leaders from eleven (11) municipalities in three different Colombian departments. Results show that the peasant organization structure called food community and the peasant farm participatory models for each territory are strategies that have led to the strengthening of the local autonomy of the peasant communities for the defense of food sustainability practices within their contexts.

Resumo Este artigo apresenta os resultados do estudo “Escritório virtual de 10.000 fazendas camponesas sustentáveis das regiões de Santander e Magdalena Medio”. O estudo tem como foco um movimento social colombiano para a preservação da fazenda camponesa como eixo central para a sustentabilidade alimentar nos territórios. Seu objetivo principal é identificar o processo de organização de quatorze (14) comunidades de alimentos e o desenho participativo do modelo de fazenda camponesa como estratégias para a segurança alimentar nos territórios colombianos de Magdalena Medio e Santander. O estudo conduziu uma metodologia mista com análise quantitativa transversal qualitativa e descritiva, com dados coletados das comunidades participantes. A coleta de dados foi feita por meio de grupos focais com sete (7) comunidades e quatorze (14) entrevistas com líderes comunitários do setor de alimentos de onze (11) municípios em três diferentes departamentos colombianos. Os resultados demonstram que a estrutura de organização camponesa denominada comunidade do alimento e os modelos participativos de propriedades camponesas para cada território são estratégias que levaram ao fortalecimento da autonomia local das comunidades camponesas para a defesa de práticas de sustentabilidade alimentar dentro de seus contextos.

Introduction: Atrial myopathy and fibrosis constitute a pro-arrhythmic and pro-thromboembolic substrate in patients with atrial fibrillation (AF). Recent studies using left atrial strain (LAS) have shown that LAS contributes to predict AF recurrence in patients with paroxysmal AF. The association between LAS and cardiac biomarkers in predicting silent stroke (SS) in patients with new AF has not been studied. Aim: The association of LAS and cardiac biomarkers contribute to predict SS in patients with new AF. Methods: We have prospectively evaluated 57 consecutive patients with new AF (first episode with less than 8 weeks of evolution). Baseline clinical characteristics and blood samples for determinations of Pro-BNP, D-Dimer and GDF-15 were obtained. Brain magnetic resonance (BMRI) and 2D Echo were performed within 3 days. In sinus rhythm, the positive deflection during ventricular systole of the LAS curve derived from speckle tracking was considered (mean of 5 cycles) (LASS). Mann Whitney U test and Spearman Rho were used for statistical analysis. Results: Mean age was 70±8,2 years, 70% were men. The mean CHA2DS2-VASc score was 3,1±1. Mean pro-BNP, D-Dimer and GDF-15 were 96,1±12,4 pg/ml, 990±140 ng/ml and 12 ng/ml, respectively. Fifteen percent of patients (n=9) had evidence of previous SS in BMRI. Patients with SS had significantly less LASS than patients without events (5,5±1,1% and 14,6±7,3% respectively p=0,04). In addition, a significant correlation between LASs and pro-BNP, D-Dimer and GDF-15 was found. Conclusion: Evidence of SS was found in 15% of patients with new AF. This was associated with LASs impairment, which was inversely correlated with cardiac biomarkers of LV overload, thrombogenesis and LA fibrosis. These findings could be utilized for a better risk stratification of stroke in patients with new AF.

Introducción: La miopatía y fibrosis auricular representan el sustrato protrombótico y proarrítmico en pacientes con fibrilación auricular (FA). Estudios recientes muestran relación entre el strain auricular izquierdo (SAI), eventos cardiovasculares y recurrencia en pacientes con FA. La asociación entre SAI y bio-marcadores cardíacos como predictores de accidente cerebrovascular silente (ACVs) en pacientes con FA de reciente comienzo (FArc) no ha sido estudiada. Objetivo: Determinar si la asociación entre SAI y biomarcadores cardíacos contribuye a la predicción de ACV en pacientes con FArc. Métodos: Se realizó un estudio prospectivo que permitió reclutar 57 pacientes con FArc (primer episodio de < de 8 semanas de evolución). Obtenido consentimiento informado (CI) se realizó recolección de datos clínicos y muestras de sangre para determinación de Pro-BNP, Dimero-D y GDF-15. Se realizó resonancia nuclear magnética cerebral (RNMc) y ecocardiograma transtorácico (ETT) durante los primeros 3 días de inclusión y en ritmo sinusal. Para la evaluación de SAI se consideró la curva de deflexión positiva durante la sístole ventricular (SAIs), derivada de speckle tracking, considerando el promedio de 5 ciclos. Se utilizó Mann Whitney U test y Spearman Rho para análisis estadístico. Resultados: La edad promedio fue 70±8,2 años y el 70% fueron hombres. El CHA2DS2-VASc score promedio fue 3,1±1 y el promedio de pro-BNP, Di-mero-D y GDF-15 fue 96,1±12,4 pg/ml, 990±140 ng/ ml y 12 ng/ml respectivamente. 15% de los pacientes (n=9) presentaban ACVs en la RNMc al momento del diagnóstico. Se observó, además, que los pacientes con ACV presentaban un SAIs más bajo que los pacientes sin eventos (5,5±1,1% y 14,6±7,3% respectivamente p=0.04). Adicionalmente, se encontró una correlación significativa entre SAIs y pro-BNP, Dimero-D y GDF-15. Conclusiones: En este trabajo se evidenció que el 15% de los pacientes con FArc presenta ACVs al momento del diagnóstico. El SAIs bajo se correlaciona de forma inversa con los biomarcadores de sobrecarga, trombogénesis, fibrosis auricular y presencia de ACV silente. Estos resultados pueden ser utilizados para una mejor estratificación del riesgo de ACV en pacientes con FA.

Background: Social capital is an economical idea that refers to connections between individuals and entities that can be economically valuable. Aim: To establish the relationship of social capital as a health care asset, with sociodemographic variables of older women attending public health care services. Material and Methods: Chen’s Personal Social Capital scale was applied to 113 women aged between 64 and 80 years during 2014. Cronbach’s alpha of the instrument was calculated. Results: The Cronbach’s alpha of the instrument was 0.86. The average score for social capital was 23.9 points of a maximum of 50. Bridging capital scores had the higher disparity, specifically in participation in community organizations and the representation of their interest in them. Bonding capital decreased along with a higher age of interviewed women (r = -0,43, p < 0,01). Higher territorial roots were associated with a lower perception of social community resource availability (r = -0,42, p < 0,01). Conclusions: The social capital scores in these women were low. Their better support networks were close relationships and relatives. The sensation of solitude increased with age.

RESUMO Objetivo: estimar a magnitude da percepção da invisibilidade da vulnerabilidade social e suas consequências no acesso aos serviços universais e específicos do Sistema de Proteção Integral à Infância no Chile. Método: estudo transversal em 50 díades vulneráveis, registrados em um centro de saúde familiar (Região Metropolitana, Chile; 2012). Depois do consentimento informado, as mães foram entrevistadas usando um questionário estruturado. Um modelo de análise de correspondência foi aplicado. Resultados: a invisibilidade da vulnerabilidade social foi estimada para mães (92.0%) e filhos (86.0%), observando-se um melhor acesso aos serviços universais pelas crianças e aos específicos pelas mães. Conclusão: a invisibilidade da vulnerabilidade limita as oportunidades de proteção social a grupos em desvantagem. Consequentemente, a política pública não corrige as desigualdades sociais, que merecem a atenção dos gestores da saúde pública chilena.

ABSTRACT Objective: To estimate the magnitude of perception of invisibility of social vulnerability and its impact on the access to universal and specific services of the Comprehensive Childhood Protection System in Chile. Method: Cross-sectional study in 50 vulnerable dyads, who were registered in a family health care center (Metropolitan Region, Chile; 2012). After the informed consent, mothers were interviewed using a structured questionnaire. A correspondence analysis model was applied. Results: The invisibility of social vulnerability estimated for mothers (92.0%) and children (86.0%), and a better access was observed to universal services by children and to specific services by mothers. Conclusion: The invisibility of vulnerability limits the opportunities of social protection for disadvantaged groups. Therefore, public policy does not correct social inequalities, which deserve attention by the public health managers in Chile.

RESUMEN Objetivo: estimar la magnitud de la percepción de la in-visibilidad de la vulnerabilidad social y sus consecuencias en el acceso a servicios universales y específicos del Sistema de Protección Integral de la Infancia en Chile. Método: estudio transversal en 50 díadas vulnerables, registradas en un centro de salud familiar (Región Metropolitana, Chile; 2012). Después de la firma de consentimiento informado, las madres fueran entrevistadas usando un cuestionario estructurado. Se aplicó un modelo de análisis de correspondencias. Resultados: la in-visibilidad de la vulnerabilidad social fue estimada para madres (92.0%) y hijos (86.0%), observándose un mejor acceso a los servicios universales a los infantes y específicos a las madres. Conclusión: la in-visibilidad de la vulnerabilidad limita las oportunidades de protección social a grupos desventajados. Como consecuencia, la política pública no corrige las desigualdades sociales, que merecen atención de los gestores de la salud pública chilena.

ABSTRACT Objective: To estimate the magnitude of perception of invisibility of social vulnerability and its impact on the access to universal and specific services of the Comprehensive Childhood Protection System in Chile. Method: Cross-sectional study in 50 vulnerable dyads, who were registered in a family health care center (Metropolitan Region, Chile; 2012). After the informed consent, mothers were interviewed using a structured questionnaire. A correspondence analysis model was applied. Results: The invisibility of social vulnerability estimated for mothers (92.0%) and children (86.0%), and a better access was observed to universal services by children and to specific services by mothers. Conclusion: The invisibility of vulnerability limits the opportunities of social protection for disadvantaged groups. Therefore, public policy does not correct social inequalities, which deserve attention by the public health managers in Chile.

RESUMEN Objetivo: estimar la magnitud de la percepción de la in-visibilidad de la vulnerabilidad social y sus consecuencias en el acceso a servicios universales y específicos del Sistema de Protección Integral de la Infancia en Chile. Método: estudio transversal en 50 díadas vulnerables, registradas en un centro de salud familiar (Región Metropolitana, Chile; 2012). Después de la firma de consentimiento informado, las madres fueran entrevistadas usando un cuestionario estructurado. Se aplicó un modelo de análisis de correspondencias. Resultados: la in-visibilidad de la vulnerabilidad social fue estimada para madres (92.0%) y hijos (86.0%), observándose un mejor acceso a los servicios universales a los infantes y específicos a las madres. Conclusión: la in-visibilidad de la vulnerabilidad limita las oportunidades de protección social a grupos desventajados. Como consecuencia, la política pública no corrige las desigualdades sociales, que merecen atención de los gestores de la salud pública chilena.

RESUMO Objetivo: estimar a magnitude da percepção da invisibilidade da vulnerabilidade social e suas consequências no acesso aos serviços universais e específicos do Sistema de Proteção Integral à Infância no Chile. Método: estudo transversal em 50 díades vulneráveis, registrados em um centro de saúde familiar (Região Metropolitana, Chile; 2012). Depois do consentimento informado, as mães foram entrevistadas usando um questionário estruturado. Um modelo de análise de correspondência foi aplicado. Resultados: a invisibilidade da vulnerabilidade social foi estimada para mães (92.0%) e filhos (86.0%), observando-se um melhor acesso aos serviços universais pelas crianças e aos específicos pelas mães. Conclusão: a invisibilidade da vulnerabilidade limita as oportunidades de proteção social a grupos em desvantagem. Consequentemente, a política pública não corrige as desigualdades sociais, que merecem a atenção dos gestores da saúde pública chilena.

The association of environmental factors and child rearing practices with body mass index z-score (BMIZ) in children residents of Children's Homes from Floridablanca, Colombia was studied. A random sample of 176 preschool children aged 3-6 years was weighed and measured, their parents or caregiver were also measured and they answered a survey. The generalized linear model showed that BMIZ increased significantly with children's age (β=0.02), children's sex (male β=0.27), mother's occupation (homemaker β=0.29), mother's overweight (β=0.20), person who accompanies children while they eat (relatives β=0,49; anyone or non-relative β=0.40), person who cooks (grandmother β=0.55), adequate time spent on eating by children (β=0.54), and overeating (0.51). BMIZ decreased significantly with mother's occupation (looking for a job or student β=-0.43), maternal history of hypertension (β=-0.26), motivation to eat (β=-0.59) and pressure to eat (β=-0.55).

El objetivo del estudio fue determinar la asociación de factores ambientales y estilos de crianza con el puntaje z del Indice de Masa Corporal (IMCZ) en preescolares de los Hogares Infantiles de Floridablanca, Colombia. Una muestra aleatoria de 176 preescolares de 3 a 6 años fueron medidos y pesados; sus padres o cuidadores fueron medidos y respondieron una encuesta. El modelo lineal generalizado mostró que el IMCZ aumenta significativamente con la edad (β=0,02) y sexo del preescolar (masculino β=0,27), ocupación (ama de casa β=0,29) y sobrepeso de la madre (β=0,20), persona que lo acompaña mientras come (familiares β=0,49; ninguno o no familiares β=0,40), persona que prepara los alimentos (abuela β=0,55), comer en un tiempo adecuado (β=0,54), y comer demasiado (0,51). El IMCZ disminuye significativamente con la ocupación de la madre (buscando trabajo o estudianteβ=-0,43), antecedentes de hipertensión arterial maternos (β=-0,26), motivación para comer (β=-0,59), y presión para comer (β=-0,55).

Background: The program “Chile grows with you” is a part of the Chilean social protection system oriented to decrease social inequities from pregnancy (a socially secure pregnancy) to four years of age, directed to the poorest 40% of the popula-tion. Aim: To determine the incidence of social vulnerability and its determinants, starting at the gestation period. Material and Methods: Data was obtained from anonymous secondary data based on the records of the first assessment of pregnant women and from social protection surveys, provided by the Ministry of Planning and Cooperation. Results: The incidence of social vulnerability was high. However there was a disparity between the figures obtained from the social protection records and the survey carried out during the first assessment of pregnant women (91 and 27% respectively). The psychosocial risk was higher among vulnerable women (42% compared to 28% among women not considered vulnerable). This risk was associated with lack of family support, depressive symptoms, gender violence, substance abuse and maternity confl icts. Working conditions were precarious with a low level of social security, there were habitability problems, disability, dependency, female householders and a mean income below the threshold of poverty. Conclusions: Among vulnerable families, there are adverse determinants that attempt against a socially secure preg-nancy and integral development of children.