De la caracterización de la población moradora al acompañamiento en la construcción de experiencias de resistencia al despojo, en la conflictividad urbana de la ciudad de Medellín

Se sistematizan algunas iniciativas y experiencias de organización comunitaria, en proceso de construcción de territorialidad como lo son las de los participantes de la "población moradora", inmersa en los escenarios del despojo, provocado por las alianzas público-privadas del urbanismo neoliberal en el Valle de Aburrá, que al lograr convertirse en sujetos organizativos consolidan apuestas por el trabajo colectivo de transformación social. La reflexión en modo IAP da cuenta de la forma como en medio de las adversas problemáticas de su mundo de la vida, por medio del trabajo con herramientas formativas, la "población moradora" se constituye como subjetividad erguida y de resistencia, en permanente construcción de un proyecto de incidencia política.

In the midst of the advance of the urban intervention of the alliances between the officialdom and the financial guilds for the benefit of the private sector, which took place in the first two decades of the 21st century in the city of Medellín, some considerations are made on the contextual conditions in which the phenomenon of resistance of the population named dweller in the city of Medellín and the metropolitan area emerges. Thus, some initiatives and experiences of community organization are systematized, whose social subjects overcome the bets of collective work, in the midst of the adversities of the problems of their world of life of the subjectivity that lives from the dispossession by urbanism.

Utilization of facility-based HIV testing and associated factors among men who have sex with men in Shanghai / 上海预防医学

Objective:To determine the prevalence of facility-based HIV testing and its associated factors among men who have sex with men （MSM） in Shanghai. Methods:From June 2018 to December 2020， MSM were recruited by a community organization “Shanghai CSW&MSM Center （SCMC）”. A total of 3 251 MSM were included as follows： being 18 years old and above， being HIV-negative or with unknown HIV status， living in Shanghai， had homosexual behavior in the past year， and completed informed consent. Using a self-designed questionnaire， we performed an online survey powered by www.wjx.cn to collect information on demographics， sexual behavior， and facility-based HIV testing. A total of 3 240 valid questionnaires were collected. Univariate and multivariate logistic regression were used to determine the factors associated with facility-based HIV testing. Results:A total of 3 240 MSM participated in the study with mean age of （29.7±6.2） years .The prevalence of facility-based HIV testing was 63.2% （2 049/3 240）， Multivariate logistic regression showed that the participants with a college degree or above were less likely to have facility-based HIV testing（OR=0.73，P=0.008）， compared to those with lower educational background. The proportion of the MSM who sought sexual partners through the internet received facility-based testing was 68.7%. Compared to the participants with the sexual role being 0 （only be penetrated）， those being 0.5 （both penetrated and be penetrated） and 1 （only penetrated） were both more likely to have the HIV testing （both P<0.05）. Those who used condoms during the last homosexual behavior were more likely to be tested than those who did not （OR=1.39， P=0.001）. Those who had been diagnosed with sexually transmitted diseases were more likely to be tested than those who did not （OR=2.05， P<0.001）. The participants who had used HIV self-testing kits in the past were more likely to be tested than those who did not （OR=2.31， P<0.001）. Conclusion:MSM in Shanghai have lower utilization of facility-based HIV testing， which may be improved by strengthening the advocacy of facility-based HIV testing services through the internet and peer education， and innovating service models.

La mujer en la organización comunitaria y su articulación con instituciones del sector público y privado / Women in the community organization and their articulation with institutions of the public and private sector

Resumen El objetivo del presente estudio fue describir las vivencias de un grupo de mujeres pertenecientes a organizaciones comunitarias durante los procesos de negociación, diálogo y participación con instituciones del sector público y privado que prestan servicio a la ciudadanía. Corresponde a una investigación cualitativa razonada con el método fenomenológico; se seleccionaron intencionalmente cuatro participantes residentes en una comunidad urbana del municipio de Valencia, Estado Carabobo, Venezuela. La información se obtuvo a través de entrevistas semi-estructuradas. Para la sistematización de la información, se utilizó el programa computacional Atlas ti Versión Demo, el cual facilitó la formación de unidades de sentido y la estructuración de la experiencia. Los resultados señalaron que un factor de protección para las mujeres estudiadas fue el apoyo que proporciona el grupo familiar, ya que facilitó la presencia de este grupo en el escenario de la vida pública. La consolidación de las organizaciones comunitarias les ha permitido acceder a las estructuras de poder para obtener recursos o servicios en bien del colectivo. En cuanto a los procesos de articulación con las instituciones, la protesta y la presión predominaron en los discursos como la forma para convenir los recursos, los bienes y los servicios cuando sus solicitudes no fueron tomadas en cuenta.

The objective of this study was to describe the experiences of a group of women from communal organizations during the processes of negotiation, dialogue and participation with institutions of the private and public sector which lend a service to the citizenship. It belongs to a qualitative investigation reasoned with the phenomenological method; four participants were selected, from an urban community in the municipality of Valencia, Carabobo State, Venezuela. The information was obtained through semi-structured interviews. For the systematization of the information, the computer program Atlas ti Demo Version was used, which made possible the formation of units of sense and the structure for the experience. The results showed that a protection factor for studied women was the support from their family group, which facilitated the presence of this group in the public life. The consolidation of community organizations has allowed them to get access to the structures of power to obtain resources or goods for the collective sake. As for the articulation processes with the institutions, protest and pressure were dominant in the discourses as the way to agree about the resources, the goods and services when their requests were not taken seriously.

O objetivo do presente estudo foi descrever as vivências de um grupo de mulheres pertencentes a organizaçõescomunitárias durante os processos de negociação, diálogo e participaçãocom instituições do setor público e privado que prestam serviçoà cidadania. Corresponde a uma pesquisa qualitativa razoada com o método fenomenológico; selecionaram-se intencionalmente, quatro participantes residentes em uma comunidade urbana do município de Valencia, Estado de Carabobo, na Venezuela. A informação se obteve através de entrevistas semiestruturadas. Para a sistematização da informação se utilizou o programa computacional Atlas ti Versão Demo, o que facilitou a formação de unidades de sentido e a estruturação da experiência. Os resultados assinalaram que um fator de proteção para as mulheres estudadas, foi o apoio que proporciona o grupo familiar, já que facilitou a presençadeste grupo no cenário da vida pública. A consolidação das organizaçõescomunitárias, permitiu-lhes aceder àsestruturas de poder para obter recursos ou serviços para o bem-estar coletivo. No que se refere aos processos de articulaçãocom as instituições, o protesto e a pressão, predominaram nos discursos como a forma para conseguir os recursos, bens e serviçosquando as suas solicitaçõesnãoforam tomadas em consideração.

The Associations of Empowerment and Social Capital with Self-Rated Health in Communities with Poor Health / 農村醫學 地域保健

OBJECTIVES: This study was performed to identify the associations of empowerment and social capital (such as social participation and trust) with self-rated health in Korean communities with poor health. METHODS: This study used the data from community health interviews conducted at 29 administrative sections (dong, eup, or myeon) with high mortality from August to October in both 2010 and 2011 as part of the Health Plus Happiness Plus Projects in Gyeongsangnam-do Province. The study subjects comprised 6,383 individuals composed of approximately 220 adults randomly sampled from each administrative section. The empowerment was measured with five-point Likert scale responses to seven perceived control questions (two at the individual level, five at the community level). The social participation was measured with 'participation in formal and/or informal group' and trust using responses to three questions about trust of others. RESULTS: The high empowerment scores at both individual and community levels, social participation in informal groups, and high trust level had independent and significant associations with good self-rated health after adjusting for socio-demographic factors (sex, age, marital status, occupation, and food affordability) and health behaviors (smoking, alcohol drinking, and exercise) in the logistic regressions. There were weak but significant associations among empowerment, social participation, and trust levels. CONCLUSIONS: Empowerment, social participation, and trust were weakly inter-related and significantly associated with self-rated health. More studies are warranted for empowerment and other social capital indices in health promotion.

Insect herbivores associated with Baccharis dracunculifolia (Asteraceae): responses of gall-forming and free-feeding insects to latitudinal variation

The spatial heterogeneity hypothesis has been invoked to explain the increase in species diversity from the poles to the tropics: the tropics may be more diverse because they contain more habitats and microhabitats. In this paper, the spatial heterogeneity hypothesis prediction was tested by evaluating the variation in richness of two guilds of insect herbivores (gall-formers and free-feeders) associated with Baccharis dracunculifolia (Asteraceae) along a latitudinal variation in Brazil. The seventeen populations of B. dracunculifolia selected for insect herbivores sampling were within structurally similar habitats, along the N-S distributional limit of the host plant, near the Brazilian sea coast. Thirty shrubs were surveyed in each host plant population. A total of 8 201 galls and 864 free-feeding insect herbivores belonging to 28 families and 88 species were sampled. The majority of the insects found on B. dracunculifolia were restricted to a specific site rather than having ageographic distribution mirroring that of the host plant. Species richness of free-feeding insects was not affected by latitudinal variation corroborating the spatial heterogeneity hypothesis. Species richness of gall-forming insects was positively correlated with latitude, probably because galling insect associated with Baccharris genus radiated in Southern Brazil. Other diversity indices and evenness estimated for both gall-forming and free feeding insect herbivores, did not change with latitude, suggesting a general structure for different assemblages of herbivores associated with the host plant B. dracunculifolia. Thus it is probable that, insect fauna sample in each site resulted of large scale events, as speciation, migration and coevolution, while at local level, the population of these insects is regulated by ecological forces which operate in the system. Rev. Biol. Trop. 59 (3): 1419-1432. Epub 2011 September 01.

La hipótesis de heterogeneidad espacial se ha utilizado para explicar el aumento en la diversidad de especies desde los polos a los trópicos: los trópicos pueden ser más diversos ya que están conformados por una mayor cantidad de hábitats y micro-hábitats. En este estudio, la hipótesis de heterogeneidad espacial se puso a prueba evaluando la variación en la riqueza de dos gremios de insectos herbívoros (formadores de agallas y de alimentación libre) asociados con B. dracunculifolia (Asteracea) a lo largo de un gradiente latitudinal en Brasil. Las diecisiete poblaciones de B. dracunculifolia seleccionadas para el muestreo de insectos herbívoros estaban en hábitats con una estructura similar, a lo largo del límite Norte-Sur de distribución de la planta hospedera, cerca de la costa brasileña. De cada población de planta hospedera, se muestrearon treinta arbustos y se obtuvo un total de 8 201 agallas y 864 insectos de alimentación libre pertenecientes a 28 familias y 88 especies. La mayoría de los insectos que se encontraron en B. dracunculifolia estaban restringidos a un sitio específico en lugar de tener una distribución geográfica similar a la de la planta hospedera. La riqueza de especies de insectos de alimentación libre no se vió afectada por el gradiente latitudinal, por lo que se corroboró la hipótesis de heterogeneidad espacial. Mientras que la riqueza de especies de insectos formadores de agallas se correlacionó positivamente con la latitud, probablemente debido a que los insectos asociados al género Baccharis se extendieron hacia el sur de Brasil. Otros índices de diversidad y equidad estimados no variaron con la latitud para ninguno de los dos grupos de insectos herbívoros evaluados, lo que sugirie una estructura general para diferentes conjuntos de herbívoros asociados con la planta hospedera B. dracunculifolia. Por lo tanto, es probable que, la muestra de insectos en cada sitio sea resultado de eventos a gran escala, como la especiación, migración y coevolución; mientras que a nivel local la población de estos insectos está regulada por fuerzas ecológicas que operan dentro del sistema.

Cultura e empowerment: promoção à saúde e prevenção da Aids entre prostitutas no Rio de Janeiro / Culture and empowerment: health promotion and Aids prevention among prostitutes in Rio de Janeiro

Neste artigo, discutimos as dificuldades encontradas na realização de projetos de promoção à saúde entre grupos marginalizados, a partir de questionários e grupos de discussão realizados no trabalho de prevenção da aids entre prostitutas, no Mangue, no Rio de Janeiro (RJ), em 1989, passando pelas histórias de vida das prostitutas da Praça São João, em Niterói (RJ), e pelo movimento de prostitutas do Rio de Janeiro, durante a década de noventa. Na análise dos dados, observamos que, apesar de a saúde pública ver as prostitutas como um "grupo", estas raramente se viam dessa forma. Ou seja, enquanto a meta das agências de promoção à saúde e do movimento de prostitutas era a de construir uma comunidade de prostitutas que pudesse se organizar, lutando por seus direitos e cidadania, a maioria das prostitutas estudadas tinham uma representação negativa da sua atividade e, consequentemente, criavam narrativas que negavam o seu pertencimento ao grupo das prostitutas. Diante desse impasse, fica evidente a necessidade de se pensar o processo de empowerment e de organização comunitária, sempre levando em conta o contexto cultural do grupo em que se quer promover a saúde.

This paper discusses the difficulties that can arise when health promotion projects are developed within marginalized groups. This could be documented using the example of aids prevention among prostitutes. We applied questionnaires and focus group interviews were performed with prostitutes in Mangue, Rio de Janeiro in 1989. Later, during the decade of 1990, we accomplished open interviews with prostitutes who frequented São João Square in Niterói and with the leaders of the prostitutes' movement of Rio de Janeiro. During the analysis of the interviews we observed that although, from a public health point of view, prostitutes are considered as a group, they seldom represent themselves in this way. In other words, while the goal of health promotion agencies and the prostitute' movement is to build a prostitutes' grassroots movement able to organize and fight for prostitutes' rights and citizenship, most of the subjects studied believed that prostitution was an evil activity and consequently created narratives which denied their belonging to the prostitutes' community.

Articulação comunitária e promoção da saúde - perspectivas para a atuação fonoaudiológica / Community articulation and health promotion - perspectives for speech therapy

OBJETIVOS: apresentar um relato de experiência de atuação comunitária para promoção da saúde desenvolvida em uma comunidade circunscrita. MÉTODO: o estudo foi realizado em uma comunidade inserida na região metropolitana de Porto Alegre (RS) entre março e julho de 2005. Foi aplicado um questionário à população referida através de visitas domiciliares. Após concluir a aplicação dos questionários iniciamos a realização das oficinas com o objetivo de orientar a comunidade em relação à atuação fonoaudiológica e à prevenção de distúrbios da comunicação humana. RESULTADOS: dos 108 domicílios, 52 foram visitados. No local, 42,3% de moradores apresentam alguma doença crônica e 30,8% fazem uso de medicamento sistêmico. Destes, 75,7% adquirem os medicamentos comprando-os e 24,3% recebem por meio do município ou estado. Dos moradores, 80,8% apresentam água encanada, 69,2% possuem banheiro dentro de casa e, em média, residem 4 sujeitos em cada domicílio (dp=2). Em média, cada domicílio possui 1,33 crianças. Dentre os entrevistados, 40,4% referem algum tipo de alteração fonoaudiológica. CONCLUSÃO: constatamos que as condições sócio-econômicas desta comunidade estão acima da média nacional. Além disso, a maioria dos moradores não utiliza o poder público para receber a atenção integral à saúde e as questões básicas de saneamento já são disponíveis para a maioria da população.

OBJECTIVES: to present an experience report of community action for health promotion developed in a circumscribed community. METHOD: the study was conducted in a community included in the metropolitan area of Porto Alegre (RS), and between the months of March and July 2005, a questionnaire was applied to the population through such visits. After completing the questionnaires we started conducting workshops with the aim of guiding the community in relation to speech-language intervention and prevention of human communication disorders. RESULTS: of 108 households in the community, 52 were visited. On site, 42.3% of residents have a chronic disease and 30.8% use systemic medication. Of these, 75.7% purchased drugs and 24.3% received them from the federal or state governments. 80.8% of residents have piped water, 69.2% have at least one bathroom inside their home, and on average, there are 4 subjects residing in each household (sd = 2). On average, each household has 1.33 children. Among the respondents, 40.4% reported some type of disorder. CONCLUSION: we found that the socioeconomic conditions of this community are above the national average. In addition, most residents do not use government-provided health care entirely, and basic sanitation issues are already available for most of the population.

OBJETIVOS: presentar un relato de la experiencia de actuación comunitaria de promoción de la salud desarrolladas en una comunidad circunscrita. MÉTODO: el estudio se realizó en una comunidad incluida en la región metropolitana de Porto Alegre (RS), entre marzo y julio de 2005. Se aplicó un cuestionario a la población a través de visitas domicialiares. Después de completar los cuestionarios se empezó la realización de talleres con el objetivo de orientar a la comunidad sobre la actuación fonoaudiológica y la prevención los transtornos de la comunicación humana. RESULTADOS: De los 108 hogares, se visitaron 52. El 42,3% de los residentes tienian alguna enfermedad crónica y el 30,8% usaban medicación sistémica. De estos, el 75,7% adquieren los medicamentos comprarlos y el 24,3% los reciben del municipio o estado. De los residentes el 80,8% tienen agua corriente, 69,2% poseén baño dentro de la casa y un promedio de 4 sujetos que residen en cada hogar (dp= 2). En promedio, cada familia tiene 1,33 hijos. Entre los encuestados, el 40,4% reportó algún tipo de trastorno fonoaudiológico. CONCLUSIÓN: Se encontró que las condiciones socioeconómicas de esta comunidad están por encima de la media nacional. Además, la mayoría de los residentes no utilizan el gobierno para recibir atención integral a la salud y las cuestiones básicas de saneamiento están ya disponibles para la mayoría de la población.

Interação universidade e comunidade através dos movimentos sociais dos bairros Santa Luzia e Ipiranga de Juiz de Fora-MG / University and community interaction through social movements of Santa Luzia and Ipiranga neighborhoods of Juiz de Fora-MG

Este artigo fez parte do projeto de extensão Movimentos Sociais e Educação Popular: Construindo Interação entre Universidade e Comunidade, cujo objetivo era a aproximação dos discentes dos cursos de Enfermagem e Medicina da UFJF com a comunidade local, através da interação comos movimentos sociais dos bairros Santa Luzia e Ipiranga, na região Sul de Juiz de Fora. A pesquisa exploratória, de natureza quanti-qualitativa, teve como objetivos: levantar os movimentos sociais atuantes nessa região; identificar a articulação desses movimentos sociais com a população e realizar diagnóstico da atuação desses movimentos. Foram aplicados questionários semiestruturados aos 14 líderes dos movimentos sociais. Os resultados evidenciaram que os principais objetivos dos movimentos são: realização de ações de natureza assistencialista e de promoção humana;desenvolvimento de ações de lazer e cultura, doações de alimentos e artigos diversos. Eles gostariam de ampliar as ações assistencialistas, os cursos profissionalizante oferecidos e as atividades culturais. Possuem boa inserção na comunidade e recebem apoio de instituições religiosas e educacionais.

This article was part of the Social Movements and Popular Education extension project: Building Interaction between University and Community, that aimed to liaise nursing and medicine undergraduates with the local community,through an interaction with the social movements of Santa Luzia and Ipiranga neighborhoods, in the southern region of Juiz de Fora, MG, Brazil. This exploratory, quantitative qualitative study aimed to survey the social movements active in the area, identify the articulation of these social movements with the population, and diagnose the activityof these movements. Semi-structured questionnaires were applied to 14 leaders of diverse social movements. The results showed that the main objectives of the movements were: human development and assistentialism actions;leisure and cultural activities and food and goods donations. They would like to increase assistentialism actions, professional courses and cultural activities. They are well integrated into the community and receive support from religious and educational institutions.

Life Improvement Program, "Better Life without Mosquitoes and Flies" : Lessons Learned from the Postwar Development in Japan with Particular Focus on Community Participation and International Assistance / 国際保健医療

 Since the end of World War II, Japan has successfully implemented of a number of community participatory programs. A program of particular note was the community-based vector and nuisance control program, named “Better life without mosquitoes and flies”. This program was promoted by community organizations based on the concept of vector control being carried out by people within their own communities. Entomology consultants also played an important role, through monitoring and evaluation of the program. Local, middle and central government health authorities supported the activities and connected the each actor tightly.<br> The key factors that contributed to the program's success were clear role-sharing and the setting of common goals by community organizations, academic groups and government authorities. It is also worth noting that, in the immediate post-war period, Japan already possessed the core capacity required for the implementation of community-based sanitation programs introduced by General Headquarter.<br> Due to cultural and environmental differences, the program described may not be directly applicable to the ongoing challenges of vector control faced by developing countries today. However, there are still some useful lessons to be learned from the experiences in Japan.