Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.

Objetivo: Analizar los programas de promoción y prevención que han sido utilizados para el abordaje de la  obesidad infantil, desde tres aspectos: modalidades, estrategias y actores involucrados; en pro de la  generación de respuestas a esta problemática de salud pública. M...

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Autores:
Rodríguez Rojas, Yúber Liliana
Argüello Gutiérrez, Yenny Paola
Tipo de recurso:
Article of journal
Fecha de publicación:
2014
Institución:
Universidad de Caldas
Repositorio:
Repositorio Institucional U. Caldas
Idioma:
spa
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oai:repositorio.ucaldas.edu.co:ucaldas/14222
Acceso en línea:
https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/2213
Palabra clave:
Health promotion
primary prevention
obesity
children
preschool
(source: MeSH, NLM)
Promoción de la salud
prevención primaria
obesidad
niños
preescolar
(fuente: DeCS, BIREME)
Rights
openAccess
License
Derechos de autor 2014 Hacia la Promoción de la Salud
id RUCALDAS2_801c5a7810d7575806276c8236f9cc1f
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dc.title.spa.fl_str_mv Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
dc.title.translated.eng.fl_str_mv Promotion and prevention programs for the treatment of childhood obesity: a systematic review
title Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
spellingShingle Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
Health promotion
primary prevention
obesity
children
preschool
(source: MeSH, NLM)
Promoción de la salud
prevención primaria
obesidad
niños
preescolar
(fuente: DeCS, BIREME)
title_short Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
title_full Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
title_fullStr Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
title_full_unstemmed Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
title_sort Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.
dc.creator.fl_str_mv Rodríguez Rojas, Yúber Liliana
Argüello Gutiérrez, Yenny Paola
dc.contributor.author.spa.fl_str_mv Rodríguez Rojas, Yúber Liliana
Argüello Gutiérrez, Yenny Paola
dc.subject.eng.fl_str_mv Health promotion
primary prevention
obesity
children
preschool
(source: MeSH, NLM)
topic Health promotion
primary prevention
obesity
children
preschool
(source: MeSH, NLM)
Promoción de la salud
prevención primaria
obesidad
niños
preescolar
(fuente: DeCS, BIREME)
dc.subject.spa.fl_str_mv Promoción de la salud
prevención primaria
obesidad
niños
preescolar
(fuente: DeCS, BIREME)
description Objetivo: Analizar los programas de promoción y prevención que han sido utilizados para el abordaje de la  obesidad infantil, desde tres aspectos: modalidades, estrategias y actores involucrados; en pro de la  generación de respuestas a esta problemática de salud pública. Métodos: Revisión sistemática de estudios  desarrollados en 14 países entre 2007 a 2013, publicados en cinco bases de datos –LILACS, IBECS, PubMed,  Cochrane y SciELO–. Se utilizaron los términos MeSH –Health Promotion – Obesity - Children– y ecuaciones de búsqueda tanto en inglés como en español. Resultados: Se encontraron 1030 artículos, de los cuales 48  cumplieron con todos los criterios de inclusión. En estos se identificaron cuatro tendencias: diagnóstico (6  artículos), intervención (39 artículos), costo-efectividad de los programas (1 artículo) y políticas públicas (2  artículos). Conclusiones: Existen diferentes programas de promoción y prevención de la obesidad, los cuales han abordado estrategias que incluyen la práctica de la actividad física, orientaciones nutricionales, procesos  educativos y abordajes integrales, a la vez estos han vinculado distintos actores, entre ellos, padres,  docentes, organizaciones de salud, agentes políticos; sin embargo, aún no se ha logrado diseñar un  programa generalizable puesto que guardan una estrecha relación con los patrones culturales de cada  región.      
publishDate 2014
dc.date.accessioned.none.fl_str_mv 2014-12-19 00:00:00
dc.date.available.none.fl_str_mv 2014-12-19 00:00:00
dc.date.issued.none.fl_str_mv 2014-12-19
dc.type.spa.fl_str_mv Artículo de revista
Sección Artículo de revisión
dc.type.eng.fl_str_mv Journal Article
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dc.relation.citationvolume.spa.fl_str_mv 19
dc.relation.ispartofjournal.spa.fl_str_mv Hacia la Promoción de la Salud
dc.relation.references.spa.fl_str_mv Gerards SM, Dagnelie PC, Jansen MW, Van der Goot LO, De Vries NK, Sanders MR, et al. Lifestyle Triple P: a parenting intervention for childhood obesity. BMC Public Health. 2012; 12: 267-272.
Organización Mundial de la Salud [Internet]. Base de datos mundial en el índice de Masa Corporal. [acceso 11 de abril de 2013]. Disponible en: http://apps.who.int/bmi/index.jsp
Organización Mundial de la Salud [Internet]. Estrategia mundial sobre régimen alimentario, actividad física y salud. [acceso 11 de abril de 2013]. Disponible en: http://www.who.int/dietphysicalactivity/childhood_why/es/index.html
Kreichauf S, Wildgruber A, Krombholz H, Gibson EL, Vögele C, Nixon CA, et al. Critical narrative review to identify educational strategies promoting physical activity in preschool. Obesity Reviews. 2012; 13: 96-105.
Woodman JL, Harden A, Thomas J, Brunton J, Kavanagh J, Stansfield C. Searching for systematic reviews of the effects of social and environmental interventions: a case study of children and obesity. J Med Libr Assoc. 2010; 98: 140-146.
De Bock F, Fischer JE, Hoffmann K, Renz-Polster H. A participatory parent-focused intervention promoting physical activity in preschools: design of a cluster-randomized trial. BMC Public Health. 2010; 49: 49-61.
Sisson SB, Church TS, Corby M, Tudor-Locke C, Smith SR, Bouchard C, et al. Profiles of Sedentary Behavior in Children and Adolescents: The U.S. National Health and Nutrition Examination Survey, 2001-2006. Int J Pediatr Obes. 2009; 4: 353-359.
Sekhobo JP, Edmunds LS, Reynolds DK, Dalenius K, Sharma A. Trends in prevalence of obesity and overweight among children enrolled in the New York State WIC Program, 2002-2007. Public Health Reports. 2010; 125: 218-224.
Fung C, Kuhle S, Lu C, Purcell M, Schwartz M, Storey K, et al. From “best practice” to “next practice”: the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity. International Journal of Behavioral Nutrition and Physical Activity. 2012; 9: 1-9.
Wright ND, Groisman-Perelstein AE, Wylie-Rosett J, Vernon N, Diamantis PM, Isasi CR. A lifestyle assessment and intervention tool for pediatric weight management: the HABITS questionnaire. J Hum Nutr Diet. 2011; 24: 96-100.
Lindsay AC, Sussner KM, Greaney ML, Peterson KE. Latina Mother’s beliefs and practices related to weight status, feeding and the development of child overweight. Public Health Nurs. 2011; 28(2): 107-118.
Bürgi F, Meyer U, Niederer I, Ebenegger V, Marques-Vidal P, Granacher U, et al. Socio-cultural determinants of adiposity and physical activity in preschool children: A crosssectional study. BMC Public Health. 2010; 10: 733-740.
Lazzeri G, Pammolli A, Pilato V, Giacchi MV. Relationship between 879-yr-old school children BMI, parents’ BMI and educational level: a cross sectional survey. Nutrition Journal. 2011; 10: 76-83.
Goldfield GS, Harvey A, Grattan K, Adamo KB. Physical Activity Promotion in the Preschool Years: A Critical Period to Intervene. Int J Environ Res Public Health. 2012; 9:1326-1342.
Anthamatten P, Brink L, Lampe S, Greenwood E, Kingston B, Nigg C. An assessment of schoolyard renovation strategies to encourage children’s physical activity. International Journal of Behavioral Nutrition and Physical Activity. 2011; 8: 27-35
Hobin EP, Leatherdale ST, Manske S, Dubin JA, Elliott S, Veugelers P. A multilevel examination of gender differences in the association between features of the school environment and physical activity among a sample of grades 9 to 12 students in Ontario, Canada. BMC Public Health. 2012; 8:74-87.
Donnelly JE, Greene JL, Gibson CA, Smith BK, Washburn RA, Sullivan DK, et al. Physical Activity Across the Curriculum (PAAC): a randomized controlled trial to promote physical activity and diminish overweight and obesity in elementary school children. Prev Med. 2009; 49: 336-341.
Xu F, Ware RS, Tse LA, Wang Z, Hong X, Song A, et al. A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity): rationale, design and methodology of a randomized controlled trial in Nanjing city, China. BMC Public Health. 2012; 12: 316-323.
Gabriele JM, Stewart TM, Sample A, Davis AB, Allen R, Martin CK, et al. Development of an Internet-Based Obesity Prevention Program for Children. J diabetes Sci Technol. 2010; 4: 723-732.
Bravender T, Russell A, Chung R, Armstrong SC. A “novel” intervention: A pilot study of children´s literature and healthy lifestyles. Pediatrics. 2010; 125: 513-517.
Ohri-Vachaspati P, Leviton L, Bors P, Brennan L, Brownson RC, Strunk S. Strategies Proposed by Healthy Kids, Healthy Communities Partnerships to Prevent Childhood Obesity. Preventing Chronic Disease. 2012; 9: 292-301.
McKee MD, Maher S, Deen D, Blank AE. Counseling to Prevent Obesity Among Preschool Children: Acceptability of a Pilot Urban Primary Care Intervention. Annals of Family Medicine. 2010; 8: 249-255.
Galen YK, Chock MD, Nicole A. A Report on the Development of the Hawai‘i Pediatric Weight Management Toolkit. Hawai’I Medical Journal. 2011; 70: 49-51.
Rosário R, Oliveira B, Araújo A, Lopes O, Padráo P, Moreira A, et al. The Impact of an Intervention Taught by Trained Teachers on Childhood Overweight. Int J Environ Res Public Health. 2012; 9: 1355-1367.
Silva-Sanigorski A, Elea D, Bell C, Kremer P, Carpenter L, Nichols M, et al. Obesity prevention in the family day care setting: impact of the Romp & Chomp intervention on opportunities for children’s physical activity and healthy eating. Child: Care, Health and Development. 2011; 37: 385-393.
Nethe A, Dorgelo A, Kugelberg S, Van Assche J, Bujis G, Yngve A, et al. Existing policies, regulation, legislation and ongoing health promotion activities related to physical activity and nutrition in pre-primary education settings: an overview. Obesity Reviews. 2012; 13: 118-128.
Dreyhaupt J, Koch B, Wirt T, Schreiber A, Brandstetter S, Kesztyüs D, et al. Evaluation of a health promotion program in children: Study protocol and design of the cluster-randomized BadenWürttemberg primary school study [DRKS-ID: DRKS00000494]. BMC Public Health. 2012; 12: 157-168.
Honisett S, Woolcock S, Porter C, Hughes I. Developing an award program for children’s settings to support healthy eating and physical activity and reduce the risk of overweight and obesity. BMC Public Health. 2009; 9: 345-355.
Salinas J, Vio del Rio F. Programas de salud y nutrición sin política de estado: El caso de la promoción de salud escolar en Chile. Rev Chil Nutr. 2011; 38: 100-116.
Olvera N, Bush JA, Sharma SV, Knox BB, Scherer RL, Butte NF. BOUNCE: a community-based mother-daughter healthy lifestyle intervention for low-income Latino families. Obesity. 2010; 18: 102-104.
Correa NP, Murray NG, Mei, CA, Baun WB, Gor BJ, Hare NB., et al. CAN DO Houston: A Community-Based Approach to Preventing Childhood Obesity. Prev Chronic Dis. 2010; 7: 1-8.
Veldhuis L, Struijk MK, Willemieke K, Oenema A, Renders CM, Bulk-Bunschoten A, et al. ‘Be active, eat right’, evaluation of an overweight prevention protocol among 5-year-old children: design of a cluster randomised controlled trial. BMC Public Health. 2009; 9: 177-185.
Shaman T, Morales C, Amaya C, Salazar A, Jiménez A, Méndez I. Effectiveness of a diet and physical activity promotion strategy on the prevention of obesity in Mexican school children. BMC Public Health. 2012; 12: 152-164.
Llargues E, Franco R, Recasens A, Nadal A, Vila M, Perez MJ, et al. Assessment of a school-based intervention in eating habits and physical activity in school children: the AVall study. J Epidemiol Community Health. 2011; 65: 896-901.
Yam PS, Morrison R, Penpraze V, Westgarth C, Ward DS, Mutrie N, et al. Children, parents, and pets exercising together (CPET) randomised controlled trial: study rationale, design, and methods. BMC Public Health. 2012; 12: 208-217.
Skouteris H, McCabe M, Swinburn B, Hill B. Study protocol Healthy eating and obesity prevention for preschoolers: a randomised controlled trial. BMC Public Health. 2010; 10: 220-228.
Slusser W, Staten K, Stephens K, Liu L, Yeh C, Armstrong S, et al. Payment for Obesity Services: Examples and Recommendations for Stage 3 Comprehensive Multidisciplinary Intervention Programs for Children and Adolescents. Pediatrics. 2011; 0480H: S78-S85.
Rudolf MC, Hunt C, George J, Hajibagheri K, Blair M. HENRY: development, pilot and long-term evaluation of a programme to help practitioners work more effectively with parents of babies and pre-school children to prevent childhood obesity. Child: Care, Health and Development. 2010; 36: 850-857.
Roth K, Mauer S, Obinger M, Ruf KC, Graf C, Kriemler S, et al. Prevention through Activity in Kindergarten Trial (PAKT): A cluster randomised controlled trial to assess the effects of an activity intervention in preschool children. BMC Public Health. 2010; 10: 410-419.
Hendriks AM, Gubbels JS, De Vries NK, Sediell JC, Kreners SP, Jansen MW. Interventions to Promote an Integrated Approach to Public Health Problems: An Application to Childhood Obesity. J Environ Public Health. 2012; 2012: 1-14.
Morgan PJ, Lubans DR, Plotnikoff RC, Callister R, Burrows T, Fletcher R, et al. The ‘Healthy Dads, Healthy Kids’ community effectiveness trial: study protocol of a community-based healthy lifestyle program for fathers and their children. BMC Public Health. 2011; 11: 876-889.
Borys JM, Le Bodo Y, Jebb SA, Seidell JC, Summerbell C, Ridchard D, et al. EPODE approach for childhood obesity prevention: methods, progress and international development. Obesity Reviews. 2012; 13: 299-315.
Verbestel V, De Henauw S, Maes L, Haerens L, Marild S, Eiben G, et al. Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention. International Journal of Behavioral Nutrition and Physical Activity. 2011; 8: 82-96.
Plotnikoff RC, Lightfoot P, Barret L, Spinola C, Predy G. A Framework for Addressing the Global Obesity Epidemic Locally: The Child Health Ecological Surveillance System (CHESS). Prev Chronic Dis. 2008; 5: 1-6.
Simmons A, Mavoa HM, Bell AC, De Courten M, Schaaf D, Schultz J, et al. Creating community action plans for obesity prevention using the ANGELO (Analysis Grid for Elements Linked to Obesity) Framework. Health Promotion International. 2009; 24: 311-324.
Cousins JM, Langer SM, Rhew LK, Ches MA, Thomas C. The Role of State Health Departments in Supporting Community-Based Obesity Prevention. Prev Chronic Dis. 2011; 8: A87-98.
Silva-Sanigorski A, Prosser L, Carpenter L, Honisett S, Gibbs L, Moodie M, et al. Study protocol Evaluation of the childhood obesity prevention program Kids – ‘Go for your life’. BMC Public Health. 2010; 10: 288-295.
Ekberg J, Angbratt M, Valter L, Nordvall M, Timpka T. History matters: childhood weight trajectories as a basis for planning community-based obesity prevention to adolescents. Int J Obes (Lond). 2012; 4: 524-528.
Phillips MM, Ryan K, Raczyinski JM. Public policy versus individual rights in childhood obesity interventions: perspectives from the Arkansas experience with Act 1220 of 2003. Prev Chronic Dis. 2011; 5: A96-102.
Silva-Sanigorski A, Bolton K, Haby M, Kremer P, Gibbs L, Waters E, et al. Scaling up communitybased obesity prevention in Australia: Background and evaluation design of the Health Promoting Communities: Being Active Eating Well initiative. BMC Public Health. 2010; 10: 65-71.
Leeman J, Sommers J, Jernigan J, Payne G, Thompson D, Heiser C, et al. An evaluation framework for obesity prevention policy interventions. Prev Chronic Dis. 2012; 9: E120-128.
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spelling Rodríguez Rojas, Yúber Liliana0a6e618fa98b81e05ffd9e896a43f92e500Argüello Gutiérrez, Yenny Paola14b034f7d0e56733358ece88ab1ce8d45002014-12-19 00:00:002014-12-19 00:00:002014-12-190121-7577https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/22132462-8425Objetivo: Analizar los programas de promoción y prevención que han sido utilizados para el abordaje de la  obesidad infantil, desde tres aspectos: modalidades, estrategias y actores involucrados; en pro de la  generación de respuestas a esta problemática de salud pública. Métodos: Revisión sistemática de estudios  desarrollados en 14 países entre 2007 a 2013, publicados en cinco bases de datos –LILACS, IBECS, PubMed,  Cochrane y SciELO–. Se utilizaron los términos MeSH –Health Promotion – Obesity - Children– y ecuaciones de búsqueda tanto en inglés como en español. Resultados: Se encontraron 1030 artículos, de los cuales 48  cumplieron con todos los criterios de inclusión. En estos se identificaron cuatro tendencias: diagnóstico (6  artículos), intervención (39 artículos), costo-efectividad de los programas (1 artículo) y políticas públicas (2  artículos). Conclusiones: Existen diferentes programas de promoción y prevención de la obesidad, los cuales han abordado estrategias que incluyen la práctica de la actividad física, orientaciones nutricionales, procesos  educativos y abordajes integrales, a la vez estos han vinculado distintos actores, entre ellos, padres,  docentes, organizaciones de salud, agentes políticos; sin embargo, aún no se ha logrado diseñar un  programa generalizable puesto que guardan una estrecha relación con los patrones culturales de cada  región.      Objective: To analyze promotion and prevention programs which have been used for addressing childhood  obesity from three aspects: modalities, strategies and actors involved towards generation of responses to  this public health problem. Methods: Systematic review of studies conducted in 14 countries between 2007  and 2013 published in five databases –LILACS, IBECS, PubMed, Cochrane and SciELO–. MeSH terms were  used  –Health Promotion - Obesity - Children– and search of equations in both English and Spanish. Results:  There were 1,030 articles, of which 48 met all inclusion criteria. In these, four trends were identified:  diagnosis (6 articles), intervention (39 articles), cost-effectiveness of programs (1 article) and public policy (2  articles). Conclusions: There are different programs for promotion and obesity prevention, which have  addressed strategies that include practice of physical activity, nutritional guidance, educational processes  and comprehensive approaches, while these have linked different actors including parents, teachers, health  organizations, political agents; however, it has not yet been possible to design a program that can be  generalized because they keep a close relationship with each region cultural patterns.   application/pdfspaUniversidad de CaldasDerechos de autor 2014 Hacia la Promoción de la Saludhttps://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/2213Health promotionprimary preventionobesitychildrenpreschool(source: MeSH, NLM)Promoción de la saludprevención primariaobesidadniñospreescolar(fuente: DeCS, BIREME)Programas de promoción y prevención para el abordaje de la obesidad infantil: Una revisión sistemática.Promotion and prevention programs for the treatment of childhood obesity: a systematic reviewArtículo de revistaSección Artículo de revisiónJournal Articlehttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_dcae04bchttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTREVinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85126211119Hacia la Promoción de la SaludGerards SM, Dagnelie PC, Jansen MW, Van der Goot LO, De Vries NK, Sanders MR, et al. Lifestyle Triple P: a parenting intervention for childhood obesity. BMC Public Health. 2012; 12: 267-272.Organización Mundial de la Salud [Internet]. Base de datos mundial en el índice de Masa Corporal. [acceso 11 de abril de 2013]. Disponible en: http://apps.who.int/bmi/index.jspOrganización Mundial de la Salud [Internet]. Estrategia mundial sobre régimen alimentario, actividad física y salud. [acceso 11 de abril de 2013]. Disponible en: http://www.who.int/dietphysicalactivity/childhood_why/es/index.htmlKreichauf S, Wildgruber A, Krombholz H, Gibson EL, Vögele C, Nixon CA, et al. Critical narrative review to identify educational strategies promoting physical activity in preschool. Obesity Reviews. 2012; 13: 96-105.Woodman JL, Harden A, Thomas J, Brunton J, Kavanagh J, Stansfield C. Searching for systematic reviews of the effects of social and environmental interventions: a case study of children and obesity. J Med Libr Assoc. 2010; 98: 140-146.De Bock F, Fischer JE, Hoffmann K, Renz-Polster H. A participatory parent-focused intervention promoting physical activity in preschools: design of a cluster-randomized trial. BMC Public Health. 2010; 49: 49-61.Sisson SB, Church TS, Corby M, Tudor-Locke C, Smith SR, Bouchard C, et al. Profiles of Sedentary Behavior in Children and Adolescents: The U.S. National Health and Nutrition Examination Survey, 2001-2006. Int J Pediatr Obes. 2009; 4: 353-359.Sekhobo JP, Edmunds LS, Reynolds DK, Dalenius K, Sharma A. Trends in prevalence of obesity and overweight among children enrolled in the New York State WIC Program, 2002-2007. Public Health Reports. 2010; 125: 218-224.Fung C, Kuhle S, Lu C, Purcell M, Schwartz M, Storey K, et al. From “best practice” to “next practice”: the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity. International Journal of Behavioral Nutrition and Physical Activity. 2012; 9: 1-9.Wright ND, Groisman-Perelstein AE, Wylie-Rosett J, Vernon N, Diamantis PM, Isasi CR. A lifestyle assessment and intervention tool for pediatric weight management: the HABITS questionnaire. J Hum Nutr Diet. 2011; 24: 96-100.Lindsay AC, Sussner KM, Greaney ML, Peterson KE. Latina Mother’s beliefs and practices related to weight status, feeding and the development of child overweight. Public Health Nurs. 2011; 28(2): 107-118.Bürgi F, Meyer U, Niederer I, Ebenegger V, Marques-Vidal P, Granacher U, et al. Socio-cultural determinants of adiposity and physical activity in preschool children: A crosssectional study. BMC Public Health. 2010; 10: 733-740.Lazzeri G, Pammolli A, Pilato V, Giacchi MV. Relationship between 879-yr-old school children BMI, parents’ BMI and educational level: a cross sectional survey. Nutrition Journal. 2011; 10: 76-83.Goldfield GS, Harvey A, Grattan K, Adamo KB. 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BMC Public Health. 2010; 10: 65-71.Leeman J, Sommers J, Jernigan J, Payne G, Thompson D, Heiser C, et al. An evaluation framework for obesity prevention policy interventions. Prev Chronic Dis. 2012; 9: E120-128.Núm. 2 , Año 2014 : Julio - Diciembrehttps://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/download/2213/2124OREORE.xmltext/xml2720https://repositorio.ucaldas.edu.co/bitstream/ucaldas/14222/1/ORE.xml9bde1ce64219c2b045c92482225547cbMD51ucaldas/14222oai:repositorio.ucaldas.edu.co:ucaldas/142222021-06-13 10:12:52.956Repositorio Digital de la Universidad de Caldasbdigital@metabiblioteca.com