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En Colombia, los estudios y encuestas poblacionales han incorporado preguntas sobre consumo de tabaco en adultos, aunque no existe un cuestionario estandarizado. Se buscó identificar los estudios o encuestas que han caracterizado el consumo de tabaco en adultos en Colombia y analizar las variables que se incluyen con ese fin, según su utilidad. Se revisaron las páginas web de organismos oficiales y se realizó una revisión narrativa de los estudios y encuestas publicados hasta febrero de 2022. Se identificaron 11 estudios o encuestas que incluyeron un número variable de preguntas sobre consumo de tabaco, todos permitieron estimar prevalencias de fumadores actuales, pero no las de exfumadores. La edad objetivo del estudio no es homogénea, el ámbito es nacional en la mayoría y muestran una enorme variabilidad en las preguntas. Estandarizar los instrumentos que permiten estimar la prevalencia de consumo de tabaco debería ser una prioridad en Colombia.

BACKGROUND AND PURPOSE: To investigate the association between clinician-scored toxicities and patient-reported health-related quality of life (HRQoL), in early-stage (ES-) and locally-advanced (LA-) non-small cell lung cancer (NSCLC) patients receiving loco-regional radiotherapy, included in the international real-world REQUITE study.MATERIALS AND METHODS: Clinicians scored eleven radiotherapy-related toxicities (and baseline symptoms) with the Common Terminology Criteria for Adverse Events version 4. HRQoL was assessed with the European Organization for Research and Treatment of Cancer core HRQoL questionnaire (EORTC-QLQ-C30). Statistical analyses used the mixed-model method; statistical significance was set at p=0.01. Analyses were performed for baseline and subsequent time points up to 2 years after radiotherapy and per treatment modality, radiotherapy technique and disease stage.RESULTS: Data of 435 patients were analysed. Pre-treatment, overall symptoms, dyspnea, chest wall pain, dysphagia and cough impacted overall HRQoL and specific domains. At subsequent time points, cough and dysphagia were overtaken by pericarditis in affecting HRQoL. Toxicities during concurrent chemo-radiotherapy and 3-dimensional radiotherapy had the most impact on HRQoL. Conversely, toxicities in sequential chemo-radiotherapy and SBRT had limited impact on patients' HRQoL. Stage impacts the correlations: LA-NSCLC patients are more adversely affected by toxicity than ES-NSCLC patients, mimicking the results of radiotherapy technique and treatment modality.CONCLUSION: Pre-treatment symptoms and acute/late toxicities variously impact HRQoL of ES- and LA-NSCLC patients undergoing different treatment approaches and radiotherapy techniques. Throughout the disease, dyspnea seems crucial in this association, highlighting the additional effect of co-existing comorbidities. Our data call for optimized radiotherapy limiting toxicities that may affect patients' HRQoL.

Children’s participation in the digital environment is gaining more attention as children seem to be active audiences, selecting and developing digital skills to access and interact across multiple platforms and devices. Nonetheless, little is known about media participation from the children’s perspective. This article presents the quantitative results of a survey of 244 children aged seven to fourteen years in Colombia about their perception of media use as a form of participation. The study’s results suggest that there is a varied range of media uses for different purposes that are not exclusive to just one device or one type of media. These results are significant as they show the way children look at their media landscape and engage with it. The authors also identify children’s perception of participation as well as their feelings regarding their media engagement. This research gives particular impetus to efforts aimed at recognizing the meanings of children’s participation in the media environment beyond the political and the civic duties to the social and the playful, incorporating children’s perceptions, experiences, and roles in society.

Background: There is evidence of strong links between exposure to different risk factors and life-threatening diseases. Assessing the burden of a risk factor on the population's mortality due to a given disease provides a clear picture of these links. The estimation of attributable mortality to a risk factor is the most widely used procedure for doing this. Although different methods are available to estimate attributable mortality, the prevalence-based methodology is the most frequent. The main objective of this study is to develop guidelines and checklists to STrengthen the design and REporting of Attributable Mortality Studies using a Prevalence-based method (STREAMS-P) and also to assess the quality of an already published study which uses this methodology. Methods: The design of the guideline and checklists has been done in two phases. A development phase, where we set recommendations based on the review of the literature, and a validation phase, where we validated our recommendations against other published studies that have estimated attributable mortality using a prevalence-based method. Results: We have developed and tested a guideline that includes the information required to perform a prevalence-based attributable mortality study to a given risk factor; a checklist of aspects that should be present when a report or a paper on attributable mortality is written or interpreted and a checklist of quality control criteria for reports or papers estimating attributable mortality. Conclusion: To our knowledge, the STREAMS-P is the first set of criteria specifically created to assess the quality of such studies and it could be valuable for authors and readers interested in performing attributable mortality studies or interpreting their reliability. This paper has been funded by the competitive research grant: Instituto de Salud Carlos III, Ministry of Science and Innovation of Spain, grant number PI19/00288 and co-funded by the European Union. Sí

Resumen Introduccion y objetivos Estimar la mortalidad atribuida (MA) al consumo de tabaco en las comunidades autonomas (CCAA) de Espana en poblacion de edad ≥ 35 anos en 2017. Metodos Se estimo la MA empleando un metodo dependiente de prevalencias basado en el calculo de fracciones atribuidas poblacionales. La mortalidad observada procede del Instituto Nacional de Estadistica; las prevalencias de consumo por sexo y edad, de la Encuesta Nacional de Salud de 2011 y 2017 y la Encuesta europea de 2014, y los riesgos relativos, del seguimiento de 5 cohortes norteamericanas. Se presentan estimaciones de MA y fracciones atribuidas poblacionales para cada comunidad autonoma por causa de muerte, sexo y edad y tasas de MA especificas y ajustadas. Resultados El tabaco causo 53.825 muertes en Espana en la poblacion de 35 o mas anos (el 12,9% de la mortalidad total). La carga de MA sobre la mortalidad observada varia del 10,8% en La Rioja al 15,3% en Canarias. Tras ajustar las tasas de MA por edad, las diferencias entre CCAA se mantienen, y las tasas mas altas en los varones se observan en Extremadura y en las mujeres, en Canarias. Las tasas ajustadas de los varones se correlacionan negativamente con las de las mujeres. El porcentaje que suponen las enfermedades cardiovasculares sobre la MA total de cada comunidad autonoma oscila entre el 21,8% de Castilla-La Mancha y el 30,3% de Andalucia. Conclusiones La carga de MA al consumo de tabaco varia entre las CCAA. Realizar un analisis detallado por regiones aporta informacion relevante para la implantacion de politicas sanitarias dirigidas a frenar el impacto del tabaquismo.

Introduction: Screening for coronavirus disease 2019 (COVID-19) exposure, coupled with engaged decision making to prioritize cancer treatment in parallel with reducing risk of exposure and infection, is crucial in the management of COVID-19 during cancer treatment. After two reported case studies of imaging findings during daily computed tomography (CT)-based image-guided radio-therapy (RT) scans, a call for submission of anonymized case reports was published with the objective of rapidly determining if there was a correlation between the onset of new pulmonary infiltrates found during RT and COVID-19. We hereby report the results of the aggregate analysis. Methods: Data of deidentified case reports for patients who developed biochemically confirmed COVID-19 during RT were submitted through an online portal. Information requested included a patient's sex, age, cancer diagnosis and treatment, and COVID-19 diagnosis and outcome. Coplanar CT-based imaging was requested to reveal the presence or absence of ground-glass opacities or infiltrates. Results: A total of seven reports were submitted from Turkey, Spain, Belgium, Egypt, and the United States. Results and imaging from the patients reported by Suppli et al. and McGinnis et al. were included for a total of nine patients for analysis. All patients were confirmed COVID-19 positive using polymerase chain reaction-based methods or nasopharyngeal swabs. Of the nine patients analyzed, abnormalities consistent with ground-glass opacities or in- filtrates were observed in eight patients. Conclusions: This is the largest case series revealing the potential use of CT-based image guidance during RT as a tool for identifying patients who need further workup for COVID-19. Considerations for reviewing image guidance for new pulmonary infiltrates and immediate COVID-19 testing in patients who develop new infiltrates even without COVID-19 symptoms are strongly encouraged. (c) 2021 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Older adults walk with a shorter stride length, reduced hip range of motion (ROM) and higher cadence. These are signs of reductions in walking ability. This study investigated whether using a wireless smart insole system that monitored and provided biofeedback to encourage an extension of swing time could increase stride length and hip flexion, while reducing the cadence. Seven older adults were tested in this study, with and without the biofeedback device, in an outdoor environment. Gait analysis was performed by using GaitRite system and Xsens MVN. Repeated measures analysis demonstrated that with biofeedback, the swing time increased by 6.45%, stride length by 4.52% and hip flexion by 14.73%, with statistical significance. It also decreased the cadence significantly by 5.5%. This study has demonstrated that this smart insole system modified positively the studied gait parameters in older adults and has the potential to improve their walking ability.

Background This study sought to analyse the trend in smoking-attributable mortality (SAM) in Spain among the population aged ≥35 years across the period 1990–2018. Methods SAM was estimated by applying a prevalence-independent method, which uses lung cancer (LC) mortality as a proxy of tobacco consumption. We sourced observed mortality from the National Institute of Statistics (Spain), LC mortality rates in smokers and never smokers from the Cancer Prevention Study I–II, and relative risks from 5 US cohorts. Estimates of annual SAM by cause of death, sex and age are shown, along with crude and annual standardised SAM rates. The trend in standardised all-cause and LC rates was analysed using a joinpoint regression model. Results Tobacco caused 1 717 150 deaths in Spain in the period 1990–2018. Among men, cancers replaced cardiovascular diseases–diabetes mellitus (CVD–DM) as the leading group of tobacco-related cause of death in 1994. Among women, CVD–DM remained the leading cause of death throughout the period. Trend analysis of standardised SAM rates due to all causes and LC showed a decrease in men and an increase in women. Conclusions The tobacco epidemic in Spain across the period 1990–2018 has had an important impact on mortality and has evolved differently in both genders. SAM is expected to increase dramatically in women in the coming years. SAM data highlight the importance of including a gender perspective in SAM analyses, in designing more effective and comprehensive public health interventions and in developing gender-specific tobacco control policies to curb tobacco consumption.

Background. The standard of care for patients (pts) with an ipsilateral breast tumour recurrence (IBTR) after breast conserving therapy (BCT) is a salvage mastectomy. However there is no solid data providing a clear advantage of radical surgery for IBTR in terms of the outcome for patients with isolated local recurrence after BCT. Nevertheless, there is a growing interest in the feasibility of repeating BCT for these patients (pts). We analyzed the oncological outcomes of repeated breast-conserving therapy (rBCT) related to the immunohistochemical subtype. Materials and methods. Between 2014 and 2020, 35 pts were selected for a 2nd BCT, a new lumpectomy with accelerated partial breast re-irradiation (APBrI), and prospectively followed in three university hospitals in Barcelona. Inclusion criteria were pts older than 50y with a late (> 48m from primary treatment) isolated IBTR less than 2cm, without having primary major radiotherapy toxicity. Oncological outcomes were analyzed. Results. At IBTR, median age was 65y and median time to ITBR was 154m. Patients characteristics are shown in table 1. Tumor’s recurrence was DCIS in 5 pts (14.3%) and invasive carcinoma in 30 pts (85.7%), where Luminal A in 10 pts (33.3%), Luminal B-HER2 negative in 12 pts (40%), Luminal B-HER2 positive in 2 (6.7%), non-Luminal HER2 positive in 3 (10%) and triple negative in 3 (10%). With a median follow-up of 37 months, there were 4 relapses (11.4%), one was a 2nd IBTR (2.85%) after in-situ IBTR, and 3 were metastatic recurrences (8.6%), two after invasive and one after in-situ IBTR. Both metastatic progressions after invasive IBTR, were hormone receptor positive and HER2 negative (Luminal B). There were 2 deaths not related with breast cancer. The 2nd IBTR rate was 2.85%. Five-year regional-free survival, metastasis-free survival, and overall survival was 82.4% (95% IC 52.6 - 94.4 %), %, 84.6% (95% IC 51 - 96 %) and 93.3% (95% IC 61.2 - 99%), respectively. Conclusion. Conservative treatment with breast conserving surgery and APBrI for isolated IBTR after BCT seems like a feasible technique as an alternative to mastectomy in selected patients. Second local recurrences and overall survival are similar to the rates described for salvage mastectomy for isolated ipsilateral breast tumour recurrence. In this cohort of patients, the immunohistochemical subtype tumors with poor prognosis (HER2 positive and triple negative) did not show increase in the local recurrence rate. Table 1.Patients Characteristicsn%Histology TypeIDC2777.1ILC0DCIS514.3Others38.6Differentiation gradeWell differentiated1028.6Moderately differentiated1851.4Poorly differentiated720Estrogen-receptor statusPositive2880Negative720Progesteron-receptor statusPositive1645.7Negative1748.6Unknown25.7HER2 statusOver-expressed617.1Non-over-expressed2674.3Unknown38.6Ki67< 20 %1748.6> 20 %1337.2Unknown514.3IHC subtypeLuminal A1033.3Luminal B1240Luminal B-HER2 positive26.7Non-luminal HER2 positive310Triple negative310IBTR locatedSame quadrant1748.6Different quadrant1645.7Unknwon25.7APBrI3D-CRT927.3IORT26.1IMRT2266.7 Citation Format: Martin Espinosa-Bravo, Victoria Reyes Lopez, Clara Morales Comas, Joaquín Rivero Déniz, Javier de La Torre Fernández de Vega, Irene Vives Roselló, Christian Sisó Raber, Manuel Altabas Gonzalez, Alexandra Giraldo Marin, Inma Alonso, Nuria Argudo, Pau Nicolau, Manel Algara, Xavier Sanz, Xavier Caparrós, Gabriela Oses, Jordi Saez, María Vernet-Tomas, Meritxell Mollà. Safety of conservative surgery with accelerated partial breast re-irradiation for isolated ipsilateral breast cancer recurrence regardless of immunohistochemical subtype. A multicentric prospective study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD7-09.

Este artículo es parte del estudio denominado: “Configuraciones que emergen de la relación desarrollo sostenible-ecofeminismo: un estudio regional”, aquí se trata sobre el hecho de que los ecofeminismos son corrientes del feminismo que han planteado diversas formas de interacción con la vida humana y no humana. En ese sentido, desarrolla la propuesta de relacionamiento con los animales que ha surgido a partir de estas corrientes, en el territorio colombiano denominado “el Eje Cafetero”. -En el trabajo de campo se identificó que surge una particular relación del desarrollo sostenible y el capitalismo, con la Naturaleza y los animales. Para analizar dicha relación se acudió a teorías latinoamericanas que han puesto en discusión el tema, al igual que a mujeres de la región con experiencias de vida de su diario quehacer; de igual manera, se consideraron Planes de Desarrollo municipales y departamentales, con el fin de identificar el abordaje en materia política a partir del feminismo y los animales. El artículo concluye con la identificación que, con base en diferentes postulados ecofeministas, el relacionamiento con los animales no humanos debe ser visto a partir de la ética y la empatía. Para las diferentes corrientes ecofeministas la lucha contra la opresión debe ser integral, inclusiva y abandonar la posición de opresión dominadora al utilizar los cuerpos de otros seres vivos, igualmente vulnerables, sintientes y explotados, de forma intensiva dentro de las prácticas del desarrollo sostenible, por lo que se acude a formas de vida como el veganismo y el consumo más consciente.

The history of physiotherapy in Latin America has received little attention thus far in the English-speaking literature. In this paper, we draw on narratives from activists, educators, and professional leaders who have been instrumental in shaping the development of physiotherapy in Argentina, Colombia, and Ecuador. Physiotherapists in the Latin American countries faced many similar challenges, including developing physiotherapy in the shadow of medicine, overcoming conservative attitudes toward women professionals, and frequent social upheaval.The paper explores the disputed story of physiotherapy's origins in the polio epidemics, the influence of Swedish remedial gymnastics, and the educational colonialism of North American and European educators. We examine some of the effects of social unrest and trauma, military rule, and economic instability on the professions attempts to establish itself in the face of competition from other professions allied to medicine. And we consider the efforts taken to establish the profession's autonomy and its shifting relationship with the state.We employed two different methods for data collection to explore aspects of physiotherapy's history in Latin America from a political and socio-cultural context: 1) A reconstruction of memories from activist physiotherapists in Colombia, Ecuador, and Argentina, who have seen, lived, and promoted the development of physiotherapy in their own countries, gleaned from in-depth interviews; and 2) Analysis of secondary sources. Data were analyzed following the method described by Maynes, Pierce, and Laslett (2008), exploring personal narratives. Textual data were analyzed using documentary research (Prior, 2003) using thematic analysis, to inductively discover, and describe relevant themes about the two main guiding study questions. A constant comparative method as outlined by Boeije (2002) was used to form categories, establish boundaries, and discerning conceptual similarities between participants' narrative.Five physiotherapists were interviewed. One from Colombia, two from Argentina and two from Ecuador. Three main themes were identified: 'A Female Profession?', 'training and education', and 'Present Day in Argentina, Ecuador, and Colombia'. Tensions between the interests of the State, professionals, patients, cultures, urban and rural services, and practices are prevalent throughout physiotherapy in Argentina, Colombia, and Ecuador. Operating within these tensions is very much the reality for physiotherapists in Latin America today.Multiple histories emerge from the research, opening up a space for a more nuanced, polyphonic reading of physiotherapy in Colombia, Ecuador, and Argentina than has been heard to date.

ObjectivesOpioid-induced constipation (OIC) can affect up to 63% of all patients with cancer. The objectives of this study were to assess quality of life as well as efficacy and safety of naloxegol, in patients with cancer with OIC.MethodsAn observational study was made of a cohort of patients with cancer and with OIC exhibiting an inadequate response to laxatives and treated with naloxegol. The sample consisted of adult outpatients with a Karnofsky performance status score ≥50. The Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) and the Patient Assessment of Constipation Symptoms (PAC-SYM) were applied for 3 months.ResultsA total of 126 patients (58.2% males) with a mean age of 61.3 years (range 34–89) were included. Clinically relevant improvements (>0.5 points) were recorded in the PAC-QOL and PAC-SYM questionnaires (pConclusionsClinically relevant improvements in OIC-related quality of life, number of bowel movements and constipation-related symptoms were recorded as early as after 15 days of treatment with naloxegol in patients with cancer and OIC, with a good safety profile.

Resumen (analítico) La presencia de medios análogos y digitales en la vida de los niños, niñas y adolescentes redimensiona la discusión sobre participación infantil, centrándola en lo que ocurre en las pantallas. Realizamos un estudio cualitativo de corte descriptivo con 75 niños, niñas y adolescentes, de 7 a 14 años, de tres ciudades (Barranquilla, Cali y Bogotá). Los resultados indican que los niños, niñas y adolescentes tienen formas complejas y diversas de pensar la participación, que superan las divisiones, escalas y prescripciones adultas e institucionales, para incluir acciones de ocio, socialización y consumo cultural. Se trata de una participación heterogénea, convergente y multiplataforma que incluye actividades como generar contenidos, dar likes, hacer suscripciones, navegar, buscar tareas o simplemente ver vídeos, fotos, jugar, divertirse y socializar, mostrando intereses, subjetividades y formas de socialización infantiles en medios y TIC. Abstract (analytical) The presence of analogue and digital media in the lives of children and adolescents reshapes discussions on child participation, with an emphasis on participation that is facilitated through screens. A qualitative descriptive study was carried out with 75 children and adolescents aged 7 to 14 years old in three cities (Barranquilla, Cali and Bogotá). The results suggest that children and adolescents have complex and diverse ways of thinking about participation that go beyond adultcentric and institutional concepts such as divisions and different scales. Children conceive their own participation in terms of leisure, socialization and cultural consumption activities. Theirs is a heterogeneous, convergent and multi-platform participation that includes activities such as creating content, liking, subscribing, browsing the web, doing homework, as well as watching videos, looking at pictures, playing games, having fun and socializing. These results show children’s interests, subjectivities and forms of socialization using media and ICTs. Resumo (analítico) A presença da mídia analógica e digital na vida das crianças e adolescentes, redimensiona a discussão sobre a participação infantil enfocando o que acontece nas telas. Foi realizado um estudo qualitativo descritivo com 75 crianças de 7 a 14 anos em três cidades (Barranquilla, Cali e Bogotá). Os resultados indicam que as crianças e adolescentes têm formas complexas e diversas de pensar a participação, assim como seus papéis na mídia e no cenário digital, que vão além das divisões, escalas e prescrições de adultos e instituições. Esta participação é heterogênea, convergente e multiplataforma, que inclui atividades como a criação de conteúdo, dar likes, fazer trabalhos escolares ou simplesmente olhar vídeos, fotos, jogar, brincar e socializar; mostrando os interesses, subjetividades e formas de socialização das crianças na mídia e nas TIC.

After smoking, residential radon is the second risk factor of lung cancer in general population and the first in never-smokers. Previous studies have analyzed radon attributable lung cancer mortality for some countries. We aim to identify, summarize, and critically analyze the available data regarding the mortality burden of lung cancer due to radon, performing a quality assessment of the papers included, and comparing the results from different countries. We performed a systematic scoping review using the main biomedical databases. We included original studies with attributable mortality data related to radon exposure. We selected studies according to specific inclusion and exclusion criteria. PRISMA 2020 methodology and PRISMA Extension for Scoping Reviews requirements were followed. Data were abstracted using a standardized data sheet and a tailored scale was used to assess quality. We selected 24 studies describing radon attributable mortality derived from 14 different countries. Overall, 13 studies used risk models based on cohorts of miners, 8 used risks from residential radon case-control studies and 3 used both risk model options. Radon geometric mean concentration ranged from 11 to 83 Becquerels per cubic meter (Bq/m

Este libro que hace parte de un kit que te llevará a explorar tu entorno desde una nueva mirada. El programa de formación ciudadana Unbaniños® busca incentivar a los niños como tú a participar en la intervención de las ciudades de manera sostenible, y ¿cómo es esto?, comprendiendo el lugar donde vivimos, motivándonos a buscar soluciones colectivamente y apoyándonos en nuestras comunidades para desarrollar proyectos que aporten y mejoren nuestra ciudad.

The field of participatory research with children developed largely thanks to shared learning between different cultures, places, and disciplines. However, grand narratives and power relationships in academia inherited from colonialism and imperialism can threaten to obstruct the transformative value of this approach. In this article, we present the case of Think Big, a multinational collaboration for participatory research with children that involved adult and child coresearchers from Australia, Chile, Colombia, and the United Kingdom. Our aim was to explore how this project helped build solidarities between adult researchers from different countries and disciplines. We applied a methodology of diffraction to explore the processes and outcomes of this collaboration and presented our insights using the metaphor of a tree to explain the roots (knowledges and frameworks), trunk (ongoing collaboration and communication between the teams from different countries), branches (local projects), and fruits (research outcomes) of our work. Based on our experience, we proposed that multinational collaborations for participatory research offer important opportunities for adult researchers to collaborate with children to generate more democratic knowledge about their lives and to generate more egalitarian relationships between adult researchers from different places and backgrounds. However, it is important to anticipate that multinational collaborations are more likely to be affected by social and political upheavals, and language barriers must be overcome to decentralize academia. Also, the organizations involved in these collaborations need to develop strategies that facilitate funding, ethics clearance, and international research agreements.

To determine lung cancer mortality trends in Colombia during the period 1985-2018 in the population aged 35 years and over and identify changes in the trend.Analysis of mortality time series. The specific standardized rates by sex and age group were calculated. Using joinpoint regression, the annual percentage change in the rates was estimated and points of change were identified.During the period 1985-2018, 105 553 deaths from lung cancer were reported in the population aged 35 and over. The standardized rates exhibit a downward trend during the period 1985-2005, except in people over the age of 64.Lung cancer death rates in Colombia are trending downward. Primary and secondary prevention measures with respect to tobacco use need to be enhanced and other risk factors, such as residential radon or occupation, monitored.Determinar a evolução da mortalidade por câncer de pulmão na Colômbia no período de 1985 a 2018, na população com 35 anos de idade ou mais, e identificar mudanças na tendência.Análise de séries temporais de mortalidade. Foram calculadas taxas específicas e padronizadas por sexo e faixa etária. Por meio da regressãoNo período de 1985 a 2018, foram registradas 105.553 mortes por câncer de pulmão na população com 35 anos de idade ou mais. As taxas padronizadas demonstram tendência decrescente no período de 1985 a 2005, exceto para maiores de 64 anos.A tendência das taxas de mortalidade por câncer de pulmão na Colômbia é descendente. É necessário promover medidas de prevenção primária e secundária acerca do consumo de tabaco e monitorar outros fatores de risco, como a exposição ao radônio residencial ou a ocupação.

Resumen Objetivo: Presentar un plan de decisiones y acciones de enfermería basado en un enfoque transcultural a través del Modelo del Sol Naciente propuesto por Madeleine Leininger. Síntesis de contenido: Investigación cualitativa tipo reporte de caso, en la que participó una familia residente del área rural del municipio de Villamaría (Caldas, Colombia) entre noviembre de 2017 y septiembre de 2018. Se realizaron entrevistas semiestructuradas sobre condiciones de cuidado individual-familiar, determinantes sociales y riesgo familiar, y se aplicaron instrumentos de valoración de la familia. La información se analizó mediante la técnica de Bardin, previa sistematización en el software ATLAS.ti. Se presenta un plan de decisiones y acciones de enfermería a la luz de una valoración coherente con la cultura, resultado de la conjunción de los sistemas populares y profesionales. Se valoraron siete factores a partir del Modelo del Sol Naciente (tecnológicos, religiosos, sociales, culturales, políticos, económicos y educativos) y se seleccionó el fenómeno "sobrecarga del cuidador familiar del adulto mayor". Conclusiones: La propuesta de abordaje otorga herramientas de análisis al profesional de enfermería para brindar cuidado según necesidades, valores, creencias y modos de vida de las personas. Resumo Objetivo: Apresentar o plano de decisões e ações de enfermagem baseado em um enfoque transcultural por meio do Modelo do Sol Nascente de Madeleine Leininger. Síntese do conteúdo: Pesquisa qualitativa do tipo relato de caso, da qual participou uma família domiciliada na área rural do município de Villamaria, Caldas, Colômbia, entre novembro de 2017 e setembro de 2018. Realizaram-se entrevistas semiestruturadas sobre condições de cuidado individual-familiar, determinantes sociais e risco familiar, utilizaram-se também instrumentos de valoração da familia. A informação se analisou pela técnica de Bardin, com prévia sistematização no software ATLAS. ti. Apresenta-se um plano de decisões e ações de enfermagem à luz de uma valoração consistente com a cultura, resultado da conjunção dos sistemas populares e profissionais. Avaliaram-se sete fatores a partir do Modelo do Sol Nascente (tecnológicos, religiosos, sociais, culturais, políticos, econômicos, educativos) e se selecionou o fenômeno "sobrecarga do cuidador familiar do idoso". Conclusões: A proposta de abordagem outorga ao profissional de enfermagem ferramentas de análise para oferecer cuidado segundo necessidades, valores, crenças e modos de vida das pessoas. Abstract Objective: To introduce a nursing decision-and-action plan based on a cross-cultural approach through the Rising Sun Model created by Madeleine Leininger. Content synthesis: Qualitative research under the case report method that involved the participation of a rural family from the municipality of Villamaría (Caldas, Colombia), from November 2017 to September 2018. Semi-structured interviews were conducted on individual-family care conditions, social determinants, and family risk. Family assessment instruments were also applied. The information was analyzed using the Bardin technique, after its systematization in ATLAS.ti software. A plan for nursing decisions and actions, resulting from the conjunction of popular and professional systems, is presented in the light of an assessment consistent with culture. Seven factors were evaluated based on the Rising Sun Model (technological, religious, social, cultural, political, economic, educational), selecting the phenomenon known as "overload of elderly family caregivers." Conclusions: The suggested approach gives nursing professionals analytical tools in order to provide care according to people's needs, values, beliefs, and lifestyles.

Resumen Introducción: la formación del talento humano en enfermería requiere de la articulación, de manera imprescindible, con las Instituciones Prestadoras de Servicios de Salud (IPS). Objetivo: analizar la relación docencia-servicio para la formación de talento humano en enfermería en Colombia. Materiales y métodos: estudio de tipo descriptivo. Se envió una encuesta electrónica con preguntas estructuradas y semiestructuradas a 53 Instituciones de Educación Superior (IES). Se incluyeron instituciones con programas de enfermería y con convenios docencia-servicio para prácticas formativas. Resultados: participaron 48 programas de enfermería de IES privadas (60,4 %) y públicas (39,6 %). El 62,5 % no contaban con una IPS propia para el desarrollo de prácticas formativas en salud, situación que deriva en estructuración de convenios docencia-servicio y pagos en dinero o servicios por las IES. Las principales modalidades de contraprestación fueron capacitación del recurso humano, educación continuada y dotación tecnológica. Conclusiones: la integración docencia-servicio de universidades públicas y privadas con diferentes instituciones es necesaria en la formación integral de profesionales de enfermería. Las IES se ven abocadas a ofrecer actividades de compensación y contraprestación según su capacidad y valoración de las necesidades conjuntas. Un bajo porcentaje cuenta con IPS propias, cuya mayoría es de carácter privado. La relación docencia-servicio mejora la atención, educación, orientación a los pacientes y familiares y la credibilidad por la presencia de la academia en las unidades asistenciales. Resumo Introdução: para a formação do talento humano em enfermagem, é essencial articular-se com as instituições prestadoras de serviços de saúde (IPS). Objetivo: analisara relação ensino-serviço para a formação do talento humano em enfermagem na Colômbia. Materiais e métodos: estudo descritivo, o qual utilizou enquete eletrônica com perguntas estruturadas e semiestruturadas enviadas a 53 Instituições de Ensino Superior (IES). Foram incluídas instituições com programas de enfermagem e convênios docentes para as práticas de formação. Resultados: participaram 48 programas de enfermagem de IES privadas (60,4 %) e públicas (39,6 %). 62,5 % não contavam com IPS própria para o desenvolvimento de estágios em saúde; essa situação leva à estruturação de convênios de prestação de serviços docentes e pagamentos em dinheiro ou serviços pelas IES. As principais formas de contraprestação foram treinamento do recurso humano, educação continuada e dotação tecnológica. Conclusões: a integração ensino-serviço de universidades públicas e privadas com diferentes instituições é necessária na formação integral dos profissionais de enfermagem. As IES são forçadas a oferecer atividades de compensação e remuneração de acordo com sua capacidade e avaliação de necessidades conjuntas. Uma porcentagem baixa tem suas IPS, e a maioria é privada. A relação ensino-serviço melhora o atendimento, a educação, a orientação e a credibilidade do paciente e da família, devido à presença da academia nas unidades de atendimento. Abstract Introduction: The training of human talent in nursing requires the articulation with the health services institutions (IPS, in Spanish) as an essential feature. Objective: To analyze the teaching-service relationship for the training of human talent in nursing in Colombia. Materials and methods: Descriptive study using an electronic survey with structured and semi-structured questions sent to 53 higher education institutions (IES, in spanish). Institutions with nursing programs and teaching service agreements for training practices were included. Results: 48 nursing programs from private (60.4 %) and public (39.6 %) IES participated in this study. 62.5 % of these did not have an IPS in charge of providing their own health services for the development of training practices. This situation leads to the structuring of teaching service agreements and payments in money or services by IES. The main forms of compensation were human resource training, continuing education, and technological endowment. Conclusions: The teaching-service integration of public and private universities with different institutions is necessary for the comprehensive training of nursing professionals. IES are forced to offer compensation activities according to their capacity and assessment of joint needs. A low percentage have their own IPS, whose majority are private institutions. The teaching-service relationship improves care, education, patient and family orientation and credibility due to the presence of the academy in health care units.

Smoking-attributable mortality (SAM) is an indicator that reflects the evolution of the tobacco epidemic at the population level. The objective of this study is to identify and to describe published studies that have estimated SAM in Spain. A search in PubMed and EMBASE databases was performed, limited to studies published until April 15th, 2021. Studies that estimated SAM in Spain or its constituent regions were included. Of the 146 studies identified, 22 met eligibility criteria. The first estimate of SAM in Spain dates from 1978 and the last from 2017. Twelve of the studies found estimated SAM at national level, 8 in regions, 1 in a province and 1 in a city. Most estimates were made for adults aged over 34, categorized as smokers, ex-smokers and never smokers. Observed mortality derived, in all studies, from official records, and relative risks mostly from Cancer Prevention Study II. In the period analyzed, a decrease in the burden of SAM was observed. In Spain, different SAM estimates are available globally, but they do not have regular periodicity, and such estimates are infrequently made by region. Due to variations in methodology and data sources, it is difficult to assess changes in SAM. Having global and regional periodic estimates would be necessary to correctly monitor the tobacco epidemic in Spain.La mortalidad atribuida (MA) al consumo de tabaco es un indicador que refleja la evolución de la epidemia tabáquica a nivel poblacional. El objetivo de este trabajo es identificar y describir los estudios publicados que hayan estimado MA al consumo de tabaco en España. Se realizó una búsqueda en las bases de datos de PubMed y EMBASE de los trabajos publicados hasta el 15/04/2021. Se incluyeron estudios que estimaron MA en España en su conjunto o en unidades territoriales. Se identificaron 146 estudios y 22 cumplieron los criterios de elegibilidad. La primera estimación de MA en España data de 1978 y la última de 2017. En 12 estudios se estimó la MA a nivel nacional, 8 en comunidades autónomas, 1 a nivel provincial y 1 en una ciudad. La mayoría de estimaciones se realizaron en adultos mayores de 34 años categorizados como fumadores, exfumadores y nunca fumadores. La mortalidad observada derivó en todos los estudios de registros oficiales y los riesgos relativos mayoritariamente del Cancer Prevention Study II. En el periodo analizado se observó una disminución en la carga de MA en relación con la mortalidad total. En España se dispone de estimaciones de MA a nivel global, pero no tienen periodicidad regular y es infrecuente que se realicen en unidades territoriales. Debido a variaciones en la metodología y en las fuentes de datos es difícil evaluar de forma precisa cambios en la MA. Sería necesario disponer de estimaciones periódicas globales y regionales para monitorizar correctamente la epidemia tabáquica en España.

Smoking-attributable mortality (SAM) is an indicator that reflects the evolution of the tobacco epidemic at the population level. The objective of this study is to identify and to describe published studies that have estimated SAM in Spain. A search in PubMed and EMBASE databases was performed, limited to studies published until April 15th, 2021. Studies that estimated SAM in Spain or its constituent regions were included. Of the 146 studies identified, 22 met eligibility criteria. The first estimate of SAM in Spain dates from 1978 and the last from 2017. Twelve of the studies found estimated SAM at national level, 8 in regions, 1 in a province and 1 in a city. Most estimates were made for adults aged over 34, categorized as smokers, ex-smokers and never smokers. Observed mortality derived, in all studies, from official records, and relative risks mostly from Cancer Prevention Study II. In the period analyzed, a decrease in the burden of SAM was observed. In Spain, different SAM estimates are available globally, but they do not have regular periodicity, and such estimates are infrequently made by region. Due to variations in methodology and data sources, it is difficult to assess changes in SAM. Having global and regional periodic estimates would be necessary to correctly monitor the tobacco epidemic in Spain.

Despite the risks associated with the use of new forms of tobacco consumption, such as electronic cigarettes or heated tobacco products such as IQOS (I Quit Ordinary Smoking), few studies have estimated the prevalence of use at the population level. The aims of this study were to describe, in Galicia, the evolution of the prevalence of the use of electronic cigarettes and the reasons for its use in the period 2014-2018, and, the use and knowledge of IQOS in 2018.The information analyzed comes from 4 cross-sectional surveys conducted in 2014 (n=7,874), 2015 (n=7,908), 2017 (n=7,841) and 2018 (n=7,853) within the framework of the Information System on Risk Behaviors (SICRI), being the target population Galicians aged 16 and over. Estimates of prevalence of consumption, the devices knowledge and reasons for use are shown accompanied with 95% confidence intervals (95% CI), globally, by gender, age group and tobacco consumption.In the period under study, the prevalence of electronic cigarette use remained stable. In 2018 it was estimated at 0.7% (0.5-0.9). In 2017, the only year in which changes were observed, it fell to 0.3% (0.2-0.4). Prevalence of electronic cigarette use among the population aged 16 to 24 increased from 0.8% in 2014 to 2.1% in 2018. The main reason for using electronic cigarettes was to quit smoking. The prevalence of the IQOS use at the time study (2018) was 0.1% (0.01-0.15) and 4.2% (3.7-4.7) of the Galicians knew what the IQOS was.In Galicia, the prevalence of electronic cigarette and IQOS use is low, although an increase was observed among the population aged 16-24 between 2014 and 2018. Surveillance of use at the population level should not be neglected.A pesar de los riesgos asociados al uso de nuevas formas de consumo de tabaco, como los cigarrillos electrónicos o los productos de tabaco calentado como los IQOS (I Quit Ordinary Smoking), son pocos los estudios que han estimado su prevalencia de uso a nivel poblacional. Los objetivos de este trabajo fueron describir, en Galicia, la evolución de la prevalencia y las razones de uso de cigarrillos electrónicos en el periodo 2014-2018; y el uso y conocimiento del IQOS en 2018.La información analizada procede de 4 estudios transversales que se realizaron en 2014 (n=7.874), 2015 (n=7.908), 2017 (n=7.841) y 2018 (n=7.853) en el marco del Sistema de Información sobre Conductas de Riesgo (SICRI), siendo la población objetivo la población gallega de 16 años y más. Se presentan estimaciones puntuales de prevalencia de consumo y de conocimiento de los dispositivos y razones de uso acompañadas de intervalos de confianza al 95% (IC95%), en global, en función del sexo, el grupo de edad y el consumo de tabaco.En el periodo a estudio la prevalencia de uso de cigarrillos electrónicos se mantuvo estable. En 2018 se estimó en el 0,7% (0,5-0,9). En 2017, único año en el que se observaron cambios, se redujo al 0,3% (0,2-0,4). La prevalencia de uso de cigarrillos electrónicos entre la población de 16 a 24 años pasó del 0,8% en 2014 al 2,1% en 2018. El principal motivo de su uso de cigarrillos electrónicos fue dejar de fumar. La prevalencia de uso de IQOS en el momento del estudio (2018) fue del 0,1% (0,01-0,15) y el 4,2% (3,7-4,7) de los gallegos sabían lo que era el IQOS.En Galicia, la prevalencia de uso de cigarrillos electrónicos e IQOS es baja, aunque se observó un aumento entre la población de 16 a 24 años entre 2014 y 2018. No se debe descuidar la vigilancia del uso a nivel poblacional.

Background Dating from the 1920s and linked to the increase in mortality among smokers, tobacco has become one of the most studied health risk factors. Tobacco-use series, whether for the general population or for specific groups, are unavailable for most South American countries, something that hinders the characterisation of this risk factor. Objectives To identify and analyse studies that estimate smoking-attributable mortality (SAM) in South America and provide an overview of the impact of smoking habit on mortality in the region. Methods Systematic review using PubMed, Embase, LILACS, Biblioteca Virtual en Salud, Google Scholar and Google, and including all papers published until June 2020 reporting studies in which SAM was estimated. Results The search yielded 140 papers, 17 of which fulfilled the inclusion criteria. There were SAM estimates for all South American countries, with Argentina having the most. The first estimate covered 1981 and the latest, 2013. The method most used was prevalence-based. Regardless of the country and point in time covered by the estimate, the highest figures were recorded for men in all cases. The burden of attributable vs observed mortality varied among countries, reaching a figure of 20.3% in Argentina in 1986. The highest SAM burden was registered for the group of cardiovascular diseases. Conclusions SAM estimates are available for all South American countries but the respective study periods differ and the frequency of the estimates is unclear. For 4 countries, the only estimates available are drawn from reports, something that does not allow for a detailed assessment of the estimates obtained. To help with decision-making targeted at evaluating and enhancing the impact of smoking control policies, further studies are needed in order to update the impact of smoking on all countries across South America.

Stage III non-small cell lung cancer (NSCLC) includes a highly heterogeneous group of patients with differences in the extent and localization of disease. Many aspects of stage III disease are controversial. The data supporting treatment approaches are often subject to a number of limitations, due to the heterogeneous patient populations involved in the trials. Furthermore, the definition of stage III disease has changed over time, and early studies were frequently inadequately powered to detect small differences in therapeutic outcome, were not randomized, or had a limited follow-up times. Major improvements in therapy, including the use of more active chemotherapy agents and refinements in radiation and surgical techniques, also limit the interpretation of earlier clinical trials. Lastly, improvements in pretreatment staging have led to reclassification of patients with relatively minimal metastatic disease as stage IV rather than stage III, leading to an apparent increase in the overall survival of both stage III and IV patients. Median overall stage III NSCLC survival ranges from 9 to 34 months. Higher survival rates are observed in younger Caucasian women with good performance status, adenocarcinoma, mutations, stage IIIA, and in patients with multidisciplinary-team-based diagnoses.

Este artículo busca contribuir a la comprensión de los retos que enfrentan los docentes en relación con las transformaciones actuales que los usos de las tecnologías y los medios digitales en el aula traen consigo para la enseñanza y el aprendizaje escolar. Se presentan los principales hallazgos de una investigación en la que se diseñó y se implementó un dispositivo pedagógico de cinco etapas, en el que participaron tres docentes de distintas instituciones educativas públicas de Cali. Con este dispositivo se exploró cómo los docentes orientaron e hicieron acompañamiento a sus estudiantes en la realización de proyectos de clase, al incorporar diversos recursos digitales y lenguajes mediáticos. Los resultado sugieren que los docentes partieron de una problematización que no solamente configuró una serie de pasos a seguir, sino que también se fue actualizando en las etapas subsiguientes. Esto les exigió una movilización permanente de estrategias, recursos y competencias. Así, los docentes pusieron en marcha su agencia para resolver distintas necesidades e imprevistos a lo largo del desarrollo de cada proyecto.