DEVELOPMENT OF NURSING AS A PROFESSIONAL DISCIPLINE. DIFFERENCES IN THE LATIN AMERICAN CONTEXT / DESARROLLO DE LA ENFERMERÍA COMO DISCIPLINA PROFESIONAL. DIFERENCIAS EN EL CONTEXTO LATINOAMERICANO

It is a reflection on the consolidation of nursing as a professional discipline and the elements that, according to the scientific literature, make up this development. From there, the progress of nursing development in the Latin American context is analyzed and some aspects that may be influencing this development are identified. The academic field is pointed out as a strategic space to study and intervene in if the aim is to analyze the differentiated progress that nursing has had according to the context, and it is recognized that it is these spaces ­ the nursing training schools ­ from which the discussions that have underpinned the most significant developments of nursing as a professional discipline have been led with greater force.

Se trata de una reflexión sobre la consolidación de la enfermería como disciplina profesional y los elementos que de acuerdo con la literatura científica configuran este desarrollo. A partir de allí se analiza el avance del desarrollo de la enfermería en el contexto Latinoamericano y se identifican algunos aspectos que pueden estar influyendo sobre este desarrollo. Se señala el ámbito académico como un espacio estratégico por estudiar e intervenir si lo que se pretende es analizar el avance diferenciado que ha tenido la enfermería según el contexto, y se reconoce que son esos espacios ­las escuelas de formación en enfermería­ desde donde se han liderado con mayor fuerza las discusiones que han apuntalado los desarrollos más significativos de la enfermería como disciplina profesional.

La formación de estudiantes de enfermería en los espacios informales: potencialidades del trabajo autónomo / Nursing student's education in informal spaces: potentialities of autonomous work

Objetivo: Analizar la contribución del trabajo autónomo en los espacios informales a los procesos formativos en enfermería. Metodología: Estudio etnográfico particularista. Se realizaron 27 observaciones (4 horas cada una) con sus notas de campo, en los espacios informales de dos Facultades de Enfermería en Medellín, Colombia; y 20 entrevistas semiestructuradas a estudiantes de Enfermería. Mediante el método de las comparaciones constantes se identificaron los códigos y las categorías. Resultados: emergieron cuatro categorías. El trabajo autónomo individual: “identificar lo más importante”. “Estudiar juntos”: el trabajo autónomo en compañía de los compañeros. “Compartir experiencias”: posibilidades de formación. “Hacer varias cosas al tiempo”: caos y aprendizaje. Conclusión: Los procesos caóticos, las interacciones y el trabajo autónomo que los estudiantes de enfermería realizan en los espacios informales, contribuyen al desarrollo de habilidades comprensivas y experienciales para su formación profesional. (AU)

Objective: To analyse the contribution of autonomous work in informal spaces to educational processes in nursing. Methods: A particularistic ethnographic study was carried out. 27 observations were made with field notes in the informal spaces of two Nursing Schools in Medellín, Colombia; and 20 semi-structured interviews with nursing students. The codes and categories emerged using the method of constant comparisons. Results: Four categories were found. Individual autonomous work: “identifying what is most important”. “Studying together”: autonomous work in the company of peers. “Sharing experiences”: educational possibilities. “Do everything at the same time”: chaos and learning. Conclusions: The chaotic processes, interactions and autonomous work that nursing students carry out in informal spaces contribute to the development of comprehensive and experiential skills for their professional education. (AU)

Effect of Pruning Young Branches on Fruit and Seed Set in Cassava.

Flowering in cassava is closely linked with branching. Early-flowering genotypes branch low and abundantly. Although farmers prefer late flowering genotypes because of their erect plant architecture, their usefulness as progenitors in breeding is limited by their low seed production. In general, the first inflorescence aborts in cassava. Preventing this abortion would result in early production of seeds and make cassava breeding more efficient. The objective of this study was to assess if pruning young branches prevents the abortion of first inflorescences and promotes early fruit and seed set. Four genotypes with early, late, very late, and no flowering habits were grown under an extended photoperiod (EP) or normal dark night conditions (DN). Additional treatments included pruning young branches at the first or second flowering event and spraying (or not) benzyladenine (BA) after pruning. One genotype failed to flower and was not considered further. For the remaining genotypes, EP proved crucial to induce an earlier flowering, which is a pre-requisite for pruning. Total production of seeds in EP plots was 2,971 versus 150 in DN plots. For plants grown under EP, the average number of seeds per plant without pruning was 3.88, whereas those pruned produced 17.60 seeds per plant. Pruning at the first branching event led to higher number of seeds per plant (26.25) than pruning at the second flowering event (8.95). In general, applying BA was beneficial (38.52 and 13.98 seeds/plant with or without spraying it, respectively). The best combination of treatments was different for each genotype. Pruning young branches and applying BA in the first flowering event not only prevented the abortion of inflorescences but also induced the feminization of male flowers into hermaphrodite or female-only flowers. The procedures suggested from this study (combining EP, pruning young branches, and spraying BA), allowed the production of a high number of seeds from erect cassava genotypes in a short period. The implementation of these procedures will improve the breeding efficiency in cassava.

El aprendizaje de los estudiantes de enfermería en la interacción con el docente experto / Nursing student learning in interaction with the expert teacher / Aprendizagem do aluno de enfermagem em interação com o professor especialista

Objetivo: Describir el proceso de aprendizaje de los estudiantes de enfermería en la interacción con el docente experto. Materiales y Métodos: Investigación cualitativa, utilizando herramientas de la etnografía. Se identificó un docente reconocido como docente experto. La recolección de la información se hizo en dos fases; en la primera se realizaron observaciones durante el desarrollo de dos clases y 23 entrevistas think aloud a 6 estudiantes. En la segunda fase se realizaron 8 entrevistas a profundidad a seis estudiantes. Se realizó el análisis descriptivo y la categorización en el programa Atlas Ti. Resultados: A Partir de la interacción estudiante-docente emergieron dos categorías que describen el proceso de aprendizaje. La primera es "la interacción entre los estudiantes y el docente experto: un proceso de dos", que se desarrolla mediante la explicación, las intervenciones espontáneas de los estudiantes y los ejercicios de recapitulación. La segunda trata sobre "los aprendizajes: se quedan para la vida", los cuales se evidencian en la identificación de las diversas formas de aprender, los aprendizajes para aprender y los aprendizajes implícitos. Conclusiones: El proceso de aprendizaje en la interacción entre el docente experto y los estudiantes es dinámico, flexible y abierto. Es un espacio donde los estudiantes y el docente construyen una relación activa, propositiva y bidireccional que favorece los procesos formativos en Enfermería, haciendo que los estudiantes obtengan aprendizajes significativos.

Objective: To describe the learning process of nursing students in the interaction with the expert teacher. Materials and Methods: Qualitative research, using tools of ethnography. A teacher recognized as an expert teacher was identified. The information gathering was done in two phases. In the first, observations were made during two classes and 23 think aloud interviews with 6 students. In the second phase, 8 in-depth interviews were conducted with six students. Descriptive analysis and categorization were carried out in the Atlas Ti program. Results: From the student-teacher interaction, two categories emerged that describe the learning process. The first is "the interaction between the students and the expert teacher: a process of two", which is developed through explanation, spontaneous interventions by students and recapitulation exercises. The second deals with "learning: they stay for life", which is evidenced in the identification of the various ways of learning, learning to learn and implicit learning. Conclusions: The learning process in the interaction between the expert teacher and the students is dynamic, flexible and open. It is a space where the students and the teacher build an active, purposeful and bidirectional relationship that favors the educational processes in Nursing, making the students obtain significant learning.

Objetivo: Descrever o processo de aprendizagem dos estudantes de enfermagem na interação com o professor especialista. Materiais e métodos: Pesquisa qualitativa, utilizando ferramentas da etnografia. Um educador foi identificado como professor especialista. A coleta de informações foi realizada em duas fases. Na primeira, realizaram-se observações de duas aulas e 23 entrevistas think aloud com 6 alunos. Na segunda fase, foram realizadas oito entrevistas em profundidade com seis alunos. A análise descritiva e a categorização foram realizadas no programa Atlas Ti. Resultados: Emergiram duas categorias da interação aluno-professor que descrevem o processo de aprendizagem. A primeira é "a interação entre os alunos e o professor especialista: um processo de dois", desenvolvido por meio de explicações, intervenções espontâneas dos alunos e exercícios de recapitulação. A segunda trata do "aprendizado: permanece a vida toda", o qual se evidencia na identificação dos diferentes modos de aprender, aprendizagens para aprender e o aprendizado implícito. Conclusões: O processo de aprendizagem na interação entre o professor especialista e os alunos é dinâmico, flexível e aberto. É um espaço onde os alunos e o professor constroem uma relação ativa, proativa e bidirecional que favorece os processos de ensino em Enfermagem, fazendo com que os alunos obtenham aprendizados significativos.

Reflective and critical thinking in nursing curriculum.

OBJECTIVE: to evaluate the teaching of transversal competence of the Reflective and Critical Thinking that is fundamental in the decision-making and solution of nursing problems, in degree programs of public and private institutions in the Andean region. METHOD: multi-center, cross-sectional, exploratory-descriptive study, with mixed approach in 5 countries. RESULTS: 76 nursing programs participated in the study. The Reflective and Critical Thinking was found as a subject, subject content and didactic strategies. Of the 562 subjects reviewed, this type of thinking is found in 46% of the humanities area and 42% in the area of research and professional discipline. It is important to train teachers to achieve coherence between the pedagogical model approach, teaching strategies and evaluations. CONCLUSION: nursing programs in the Andean region contemplate the critical thinking as cognitive and personals skills of communication. They also use real situations analysis, supervised practice, simulation labs and specifically learning based in problems to develop the capacity to solve them, decision-making and develop communication skills, including analysis, synthesis and evaluation.

Significados de la maternidad para un grupo de mujeres afrodescendientes / Meanings of motherhood for a Afro-descendants women group

Objetivo: Describir los significados de la maternidad para un grupo de mujeres autoidentificadas como afrodescendientes. Metodología: Investigación cualitativa, con enfoque etnográfico. Previo aval de un Comité de Ética se realizaron observaciones no participantes, entrevistas y grupos focales. El análisis se guio por el método de las comparaciones constantes. Resultados principales: Para estas mujeres la maternidad significa una decisión libre versus un deseo creado, una responsabilidad de la mujer afro y un vínculo eterno. Conclusión principal: Los significados que estas mujeres asignaron a la maternidad confluyen en la vivencia de la maternidad como una etapa positiva pero frustrante, pues se resaltan las particularidades que responden a la cultura en relación con el machismo y la importancia de la mujer afrodescendiente en la preservación de las prácticas y creencias de su grupo étnico

Objective: Describe the meanings about motherhood for a self-identified women group as afro-descendants. Methods: Qualitative research with an ethnographic approach. Approved by an ethics committee. Non-participant observations, interviews and focus groups were made. The analysis was guided by constants comparisons method. Results: Motherhood means a free decision versus a created wish, a responsibility of the Afro-descendant women and an eternal bond. Conclusions: Meanings that these women gave to motherhood brings with the meaning that motherhood is a positive and frustrating experience at the same time because responds to the cultural particularities in regard to machismo and to the importance that the ethnic group assign to the women in the preservation of the Afro-descendants practices and beliefs

Immediate Complications of Elective Newborn Circumcision.

OBJECTIVES: To determine the incidence of immediate complications of elective newborn circumcision in 2 community teaching hospitals. METHODS: We performed a retrospective chart review of all term neonates who had circumcision performed between August 2011 and December 2014 at 2 community hospitals in New York. Neonatal hospital records and subsequent inpatient and outpatient records were reviewed. We classified complications as minor, intermediate, and major. RESULTS: Out of a total of 1115 circumcisions, 1064 met inclusion criteria. There were 41 complications (3.9%), all involving hemorrhage. Sutures were used to control hemorrhage in 3 patients (0.3%). Local pressure or application of hemostatic chemical agents controlled bleeding in the remainder of patients. Bleeding was more common with the use of the Gomco clamp than with the Mogen clamp. Circumcisions performed with Gomco clamp represented 73.2% of the total complications compared with 26.8% with the Mogen clamp. There were no injuries to structures outside the prepuce or problems requiring medical treatment after discharge from the neonatal hospitalization. CONCLUSIONS: The most common immediate complication encountered during an elective neonatal circumcision was bleeding that required only pressure or topical thrombin to achieve hemostasis. Bleeding was more common with the use of the Gomco versus the Mogen clamp. To conclude, our data support the theory that elective infant circumcision can be performed safely in a hospital setting.

Significados que construyen mujeres afrodescendientes frente al cáncer de mama y cuello uterino, atendidas en Medellín, Colombia / Meanings that build Afro-descendant women facing breast and cervical cancer, who were attended in Medellin, Colombia

Resumen Introducción: La investigación sobre la salud de mujeres afrodescendientes es escasa en Colombia, especialmente cuando se trata de estudios que muestren relación entre etnia y cáncer. El cáncer de mama (CaMa) y cuello uterino (CaCu) requieren ser investigados desde la voz de las mujeres afrodescendientes que lo padecen. Objetivo: Comprender los significados frente al CaMa o CaCu que construyen mujeres afrodescendientes atendidas en los servicios de salud de Medellín, Colombia. Materiales y métodos: Investigación cualitativa con enfoque etnográfico. Se realizaron entrevistas semiestructuradas a mujeres con CaMa y CaCu y grupos focales con población afrodescendiente sin cáncer; observaciones en citas médicas, quimioterapia y lugares cotidianos. El análisis fue guiado por el método de comparación constante. Resultados: Emergieron tres categorías: "El señor cáncer" que da cuenta de la enfermedad concebida como fatal y peligrosa, "La enfermedad desplaza", producto de la migración de las mujeres a Medellín para recibir tratamientos; y "Parte la vida en dos" por los cambios que conlleva la enfermedad. Conclusión: La enfermedad se concibió más allá de lo biológico al experimentar una alteración de la vida social, familiar y emocional. Se requiere mayor visibilidad del proceso salud-enfermedad de las afrodescendientes, por su rol ancestral como cuidadoras y forjadoras de unidad familiar.

Abstract Introduction: Research on the health of Afro-descendant women is scarce in Colombia, especially when it comes to studies that show the relationship between ethnicity and cancer. Breast cancer and cervix need to be investigated from the voice of Afro-descendant women who suffer from it. Objective: To understand the meanings facing breast or cervix cancer that are built by Afro-descendant women in the health services of Medellin, Colombia. Materials and methods: A qualitative research with an ethnographic approach was made. Semi-structured interviews were conducted for women with breast and cervix cancer and there were focal groups with Afro-descendant population without cancer with observations in medical appointments, chemotherapy and everyday places. The analysis was guided by the Constant Comparative method. Results: Three categories emerged: "Lord Cancer" which accounts for the disease conceived as fatal and dangerous, "the disease displaces", product of the migration of women to Medellin to receive treatments; and "it parts life in two" because of the changes that the disease brings. Conclusion: The disease was conceived beyond the biological part by experiencing an alteration of social, familiar and emotional life. There is a need for greater visibility of the health-disease process of the afro-descendants, or their ancestral role as caregivers and family unit builders.

Breastfeeding Education: disagreement of meanings / La educación para la lactancia materna: desencuentro de significados / A educação para a lactância materna: desencontro de significados

Objective.This work sought to analyze how educational processes have been developed for breastfeeding in a health institution, starting from the meanings mothers, families, and health staff construct thereon. Methods. This was qualitative research of ethnographic approach, which included observations during the group educational activities of the programs, focal groups, and interviews of mothers, their families, and the health staff of a hospital unit in the city of Medellín, Colombia. The analysis was guided by the constant comparison method. Results. The categories emerging from the data were: 1) breast milk is an ideal food. 2) The mothers' experiences influence upon the breastfeeding practice. 3) Family beliefs sometimes operate as cultural barriers. 4) Disagreements are revealed in the educational process. Conclusion. The way educational processes have taken place for breastfeeding reveals a break expressed by the scarce interaction between the meanings professionals have constructed on the topic and those the mothers and their families give to the experience of breastfeeding.

Objetivo.Analizar la forma cómo se han desarrollado los procesos educativos para la lactancia materna (LM) en una institución de salud, partiendo de los significados que las madres, sus familias y personal de salud construyen al respecto. Métodos. Investigación cualitativa de enfoque etnográfico, que incluyó observaciones durante las actividades educativas grupales de los programas, grupos focales y entrevistas a madres, sus familias y al personal de salud de una Unidad Hospitalaria de la ciudad de Medellín, Colombia. El análisis fue guiado por el método de las comparaciones constantes. Resultados. Las categorías emergentes a partir de los datos fueron: 1) La leche materna es un alimento ideal. 2) Las experiencias de las madres inciden en la práctica de la LM. 3) Las creencias familiares operan en ocasiones como barreras culturales. 4) Se revelan desencuentros en el proceso educativo. Conclusión. La forma cómo se han cumplido los procesos educativos para la LM revela un quiebre que se expresa en la escasa interacción entre los significados que los profesionales han construido sobre el tema y los que las madres y sus familias dan a esta experiencia.

Objetivo.Analisar a forma como se desenvolveu os processos educativos para a lactância materna (LM) numa instituição de saúde, partindo dos significados que mães, famílias e pessoal de saúde constroem ao respeito. Métodos. Investigação qualitativa de enfoque etnográfico, que incluiu observações durante as atividades educativas grupais dos programas, grupos focais e entrevistas a mães, suas famílias e ao pessoal de saúde de uma Unidade Hospitalar da cidade de Medellín, Colômbia. A análise foi guiado pelo método das comparações constantes. Resultados. As categorias emergentes a partir dos dados foram: 1) O leite materno é um alimento ideal. 2) As experiências das mães incidem na prática da LM. 3) As crenças familiares operam em ocasiões como barreiras culturais. 4) Se revelam desencontros no processo educativo. Conclusão. A forma como se cumpriu os processos educativos para a LM revela um quebre que se expressa na escassa interação entre os significados que os profissionais construíram sobre o assunto e os que as mães e suas famílias dão à experiência na LM.

Sentidos construidos frente a la educación para la salud en estudiantes, docentes y egresados de programas de educación superior del área de la salud / Constructs and conceptions facing education for health students, teachers and graduates of higher education programs in the area of health

RESUMEN Antecedentes: la Educación para la Salud (EpS) es un campo de conocimiento relevante en las disciplinas del área de la salud, pero su desarrollo no ha sido coherente. Objetivo: comprender los sentidos de EpS que tienen estudiantes, docentes y/o egresados de cinco programas de educación superior del área de la salud. Materiales y métodos: diferentes estudios cualitativos en cinco unidades académicas de dos instituciones universitarias de Medellín. Se hicieron observaciones, entrevistas y grupos focales con estudiantes, docentes y/o egresados. Resultados: la EpS no tiene una identidad definida; su diversidad de concepciones guarda relación con los significados atribuidos a la educación y la salud. Así, hay posturas que van desde perspectivas morbicéntricas de la salud con críticas a la educación tradicional, a otras miradas críticas de la salud que adoptan discursos y prácticas tradicionales respecto a la educación. Se configura así un amplio espectro de matices que arroja una visión variopinta de la EpS. Conclusión las concepciones de EpS son producto de diversas posturas teóricas y metodológicas de los participantes con respecto a la educación y la salud, que evidencian tensiones entre los discursos al interior de las disciplinas y pugnas conceptuales que generan confusión entre los formadores y quienes son formados.

ABSTRACT Background: Health Education is a field of knowledge relevant to the health disciplines but its development has not been coherent. Objective: To understand student, faculty, and /or alumni conceptions of health education in five higher education programs in the health field. Materials and methods: Various qualitative methods were undertaken within five academic units in two of Medellin's universities, including observations, interviews and focus groups developed by students, faculty and/or alumni. Results: Health Education is not well defined; the diverse conceptions are related to the significant attributes of both the health and education fields. As such, there are views of health education that critique traditional education, and other views that critique health and adopt more traditional rhetoric and practices mainstream to education. This creates a wide spectrum that makes up the multifaceted vision and understanding of Health Education. Conclusion: Current conceptions of Health Education are a product of diverse theoretical and pedagogic positions with respect to education and health, which highlights differences between the disciplines and among the various conceptions of both the trainers and the trainees.

Breastfeeding Education: disagreement of meanings.

OBJECTIVE: This work sought to analyze how educational processes have been developed for breastfeeding in a health institution, starting from the meanings mothers, families, and health staff construct thereon. METHODS: This was qualitative research of ethnographic approach, which included observations during the group educational activities of the programs, focal groups, and interviews of mothers, their families, and the health staff of a hospital unit in the city of Medellín, Colombia. The analysis was guided by the constant comparison method. RESULTS: The categories emerging from the data were: 1) breast milk is an ideal food. 2) The mothers' experiences influence upon the breastfeeding practice. 3) Family beliefs sometimes operate as cultural barriers. 4) Disagreements are revealed in the educational process. CONCLUSION: The way educational processes have taken place for breastfeeding reveals a break expressed by the scarce interaction between the meanings professionals have constructed on the topic and those the mothers and their families give to the experience of breastfeeding.

Contrasting strategies to cope with drought conditions by two tropical forage C4 grasses.

Drought severely limits forage productivity of C4 grasses across the tropics. The avoidance of water deficit by increasing the capacity for water uptake or by controlling water loss are common responses in forage C4 grasses. Napier grass (Pennisetum purpureum) and Brachiaria hybrid cv. Mulato II are tropical C4 grasses used for livestock production due to their reputed resistance to drought conditions. However, there is scant information on the mechanisms used by these grasses to overcome water-limited conditions. Therefore, assessments of cumulative transpired water, shoot growth, leaf rolling, leaf gas exchange, dry mass production and a number of morpho-physiological traits were recorded over a period of 21 days under well-watered or drought conditions. Drought reduced shoot dry mass of both grasses by 35 %, yet each grass exhibited contrasting strategies to cope with water shortage. Napier grass transpired most available water by the end of the drought treatment, whereas a significant amount of water was still available for Mulato II. Napier grass maintained carbon assimilation until the soil was fairly dry, whereas Mulato II restricted water loss by early stomatal closure at relatively wet soil conditions. Our results suggest that Napier grass exhibits a 'water-spending' behaviour that might be targeted to areas with intermittent drought stress, whereas Mulato II displays a 'water-saving' nature that could be directed to areas with longer dry periods.

Cuídese, no meta la pata: sexualidad juvenil en escolares de Medellín (Colombia) / Take care, do not screw it up: school youth sexuality in Medellín (Colombia)

Objetivo: Discutir con escolares, mediante taller educativo, resultados de investigaciones sobre sexualidad juvenil e identificar ejes para la educación sexual y la formación de docentes. Metodología: Estudio cualitativo sobre sexualidad con escolares de grado 10o en Medellín, Colombia (2008-2011). Previo consentimiento se realizaron actividades educativas sobre imagen corporal, disonancia cognitiva, maternidad y paternidad adolescente, derechos de la comunidad LGBTI y ética sexual. Se analizaron evidencias escritas bajo la modalidad de discusión de expertos. Hallazgos: Los jóvenes reconocieron la sexualidad como asunto central que requiere apropiación del cuerpo, reflexividad y comunicación efectiva con padres y maestros; sin embargo, prevalece en ellos la visión trágica de la vivencia sexual. Conclusión: Los adolescentes requieren educación para la libertad, donde participen de espacios propuestos para ellos o creados por ellos, según sus necesidades y contextos y puedan tomar decisiones autónomas y responsables (AU)

Objective: Discuss with students through educational workshop results of research on youth sexuality and identify lines for sexual education and teacher training. Methods: Qualitative study on sexuality with 10th grade students from Medellin, Colombia (2008-2011). Prior signature of consents, educational activities were conducted about body image, cognitive dissonance, teenage parenthood, LGBT's community rights and sexual ethics. We analyzed written evidence trough the expert discussion form. Findings: Youth recognize sexuality as central issue that requires appropriation of their body, reflexivity and effective communication with parents and teachers, however, prevails in them a tragic vision of their sexual experiences. Conclusions: Adolescents need education for freedom, in which, they participate on sites proposed for them and created by them, according to their needs and contexts, so that they can make independent and responsible decisions (AU)

Knowledge of HIV transmission and condom use among HIV-positive heterosexual men and women in Guatemala.

BACKGROUND: The prevalence of HIV/AIDS in Guatemala among the general population is 0.79%, and 94% of transmission is directly related to sexual contact. Studies have been conducted on high- prevalence HIV-positive populations (men who have sex with men, commercial sex workers and prisoners). Heterosexual transmission has gained importance in the epidemic in Central America. To our knowledge, no study addressing knowledge of mechanisms of HIV transmission and condom use has been done on HIV-positive heterosexual men and women. METHODS: A closed-ended structured interview that addressed knowledge of mechanisms of HIV transmission and condom use was conducted on 283 heterosexual HIV-positive men (54.8%) and women (45.2%) outpatients who attend the Roosevelt Hospital's Clinic of Infectious Diseases in Guatemala City. Differences between selected characteristics were examined for significance using the Chi-square test. A multiple logistic regression was done to determine socio-demographic variables associated with inconsistent condom use. RESULTS: Of the interviewed persons, 68.5% were either living with a partner or married, and 94.3% were currently using antiretroviral therapy. Most respondents knew the mechanisms of transmission of HIV. 81.7% and 87.3% reported always using a condom with their regular and casual sexual partner in the past year, respectively. There was no statistically difference in condom use according to the patient's formal education, gender, type of partner (regular or casual)or number of sexual partners. According to the interviewees, 72% of sexual partners in the past year were either HIV negative or of an unknown serostatus. Potentially, these HIV-negative persons are at risk of contracting the virus. Among the main reasons given for not using a condom were: "my partner did not want to use a condom"; and "the condom irritates or makes my partner uncomfortable". CONCLUSIONS: Since no socio-demographic or sexual behavior variable was associated with inconsistent condom use, we recommend intensive and regular condom counselling for every heterosexual HIV-positive outpatient who attends the clinic. Further studies should be done to determine condom use negotiation between partners; and to determine social, interpersonal and psychological factors that might affect the decision to use a condom or not.

El análisis de los datos cualitativos: un proceso complejo / The analysis of qualitative data: a complex process

Este artículo muestra la complejidad del análisis de los datos cualitativos a partir de las ideas sobre el método planteadas por Morin y surge fruto del proceso analítico llevado a cabo durante la elaboración de nuestras tesis doctorales. Nuestra experiencia parte del método de las comparaciones constantes y representa un desafío dotado de contradicciones complementarias, donde los datos se agrupan y desagrupan, se integran y se desintegran de acuerdo con los principios hologramático, dialógico y recursivo. Como resultado establecemos las siguientes fases del proceso de análisis: 1) "El todo": desarrollando ideas; 2) Del todo a las partes: separando y agrupando; 3) De lo particular a lo general: re-agrupando; 4) Descomponer el todo en sus partes sin perder el todo: integrando y relacionando; 5) Relacionar las partes que dan sentido al todo: identificando la categoría central (AU)

This article shows the complexity of the analysis of qualitative data according to Morin's method and they are the result of the analytical process carried out during the development of our PhD thesis. Our experience begins with the constant comparison method and represents a challenge endowed with complementary contradictions, where data is grouped and ungrouped, integrated and disintegrated according to the hologrammatic, dialogic and recursive principles. As a result we establish the following analytical phases: 1) "The all": developing the ideas; 2) From "the all" to the parts: separating and clustering; 3) From particular to general: regrouping; 4) Undoing "the all" into its parts without losing "the all": integrating and relating; 5) Joining the parts that make sense of "the all": identifying the core category (AU)

Adrenalectomía laparoscópica: reporte de un caso / Laparoscopic adrenalectomy case report

Se practicó adrenalectomía laparoscópica a una paciente femenina de 49 años de edad, con diagnóstico de tumor suprarrenal derecho con hiperaldosteronismo primario. El abordaje que se utilizó fue el laparoscópico transabdominal con cuatro puertos de trabajo. La paciente egresó en buenas condiciones, con mejoría de sus comorbilidades, sin complicaciones...

Adrenalectomía laparoscópica: reporte de un caso / Laparoscopic adrenalectomy case report

Se practicó adrenalectomía laparoscópica a una paciente femenina de 49 años de edad, con diagnóstico de tumor suprarrenal derecho con hiperaldosteronismo primario. El abordaje que se utilizó fue el laparoscópico transabdominal con cuatro puertos de trabajo. La paciente egresó en buenas condiciones, con mejoría de sus comorbilidades, sin complicaciones...(AU)