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Child-to-parent violence is a form of family violence where the children are the aggressors. OBJECTIVE: This study first aimed to analyze the psychometric validity of the Child-to-Parent Violence Questionnaire (CPV-Q) among Ecuadorian adolescents. Second, the measurement invariance across the children's sex was examined. Finally, the prevalence of child-to-parent violence (CPV) was also determined. METHODS: A total of 2084 adolescents aged 12 to 18 years participated in this study. The participants were residents of two provinces in southern Ecuador. A higher percentage of participants were women. They lived mostly with their father and mother. The married marital status of the parents was the most frequently reported. Most of the fathers and mothers of the participants completed primary education. The sampling design was probabilistic, with proportional allocation by age and quotas according to the number of inhabitants per province. The sample size was determined by using a finite population formula. All the participants were randomly selected. The CPV-Q was used to assess child-to-parent violence. The items were adapted linguistically and tailored to the Ecuadorian context. RESULTS: The questionnaire demonstrated excellent model fit and adequate reliability. Full measurement invariance was held for all scales except for the reasons subscale pertaining to fathers. Statistically significant differences were observed with respect to the sex of the aggressor, with control/domain behaviors toward both parents and psychological violence toward the mother being more frequent among daughters than sons. Similarly, reactive reasons were more frequent among daughters than sons. CONCLUSION: This study provides significant psychometric evidence on the CPV-Q in Ecuadorian adolescents along with data on the prevalence of violence against parents.
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Invasive fungal disease accounts for about 3.8â million deaths annually, an unacceptable rate that urgently prompts the discovery of new knowledge-driven treatments. We report the use of camelid single-domain nanobodies (Nbs) against fungal ß-1,3-glucanosyltransferases (Gel) involved in ß-1,3-glucan transglycosylation. Crystal structures of two Nbs with Gel4 from Aspergillus fumigatus revealed binding to a dissimilar CBM43 domain and a highly conserved catalytic domain across fungal species, respectively. Anti-Gel4 active site Nb3 showed significant antifungal efficacy in vitro and in vivo prophylactically and therapeutically against different A. fumigatus and Cryptococcus neoformans isolates, reducing the fungal burden and disease severity, thus significantly improving immunocompromised animal survival. Notably, C. deneoformans (serotypeâ D) strains were more susceptible to Nb3 and genetic Gel deletion than C. neoformans (serotype A) strains, indicating a key role for ß-1,3-glucan remodelling in C. deneoformans survival. These findings add new insight about the role of ß-1,3-glucan in fungal biology and demonstrate the potential of nanobodies in targeting fungal enzymes to combat invasive fungal diseases.
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Aspergillus fumigatus , Dominio Catalítico , Anticuerpos de Dominio Único , Anticuerpos de Dominio Único/química , Anticuerpos de Dominio Único/inmunología , Anticuerpos de Dominio Único/farmacología , Aspergillus fumigatus/inmunología , Aspergillus fumigatus/enzimología , Cryptococcus neoformans/enzimología , Cryptococcus neoformans/inmunología , Antifúngicos/química , Antifúngicos/farmacología , Animales , Ratones , Glucano Endo-1,3-beta-D-GlucosidasaRESUMEN
Lignocellulosic biomass is widely available in the world. However, a consensus has yet to be established to evaluate the biomass valorization alternatives. The chemical composition is the primary technical limitation in selecting a transformation route to obtain value-added products. In this paper, the bagasse from non-centrifuged sugar (NCS) production and Pinus patula (PP) wood chips were analyzed in terms of complete chemical composition to establish their potential for selecting the transformation routes. A strategy to select the best route based on the chemical composition was applied and a feedstock criteria model was proposed. Schemes were obtained and compared using a bioprocess selection strategy proposed in previous works. As a result, the preliminary biorefinery schemes were finally defined. The assessment of schemes derived from the outlined strategy included technical, economic, environmental, and social analyses. The environmental evaluation was complemented with a geolocation assessment, revealing a 0.75-ton CO2-eq/yr contribution to the carbon footprint for local distribution. The sustainability index for the PP biorefinery and the bagasse from NCS production was analyzed, resulting in indices of 44.8 and 60.9, respectively. These values were primarily derived from the economic and environmental analyses of both processes.
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INTRODUCTION AND IMPORTANCE: Giant cell tumors (GCTs) of bone in the carpus are rare. Carpal GCTs are usually solitary lesions; multifocal involvement is exceptional. These lesions have a higher risk of local recurrence after intralesional curettage than those in other body areas. CASE PRESENTATION: We present a case of a 28-year-old male with a six-month history of a palpable mass in the dorsal aspect of the left wrist. Physical examination revealed a 2 cm, mildly tender mass. Magnetic resonance revealed a large intermediate signal lesion involving completely hamate bone and the distal portion of the triquetrum. Histological examination confirmed a giant cell tumor of the carpus. The patient underwent en-bloc resection of the hamate bone extending to the distal part of the pyramidal. The defect was reconstructed using polymethylmethacrylate cement (PMMA), and intercarpal arthrodesis with the capitate was achieved. Follow-up at 18 months revealed a good clinical evolution, wrist range of motion of 30° of extension, 30° of flexion, and 10° of ulnar and radial deviation without evidence of tumoral recurrence. CLINICAL DISCUSSION: The current literature suggests a high incidence of local recurrence in carpal GCT, so wide excision with carpal arthrodesis is recommended, especially in Campanacci III and multifocal involvement. CONCLUSION: Carpal GCT is exceptional, mainly affecting the hamate, capitate, and scaphoid. Most literature supports wide excision of carpal GCT owing to the high recurrence rate with intralesional procedures.
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Due to the contamination and global warming problems, it is necessary to search for alternative environmentally friendly energy sources. In this area, hydrogen is a promising alternative. Hydrogen is even more promising, when it is obtained through water electrolysis operated with renewable energy sources. Among the possible devices to perform electrolysis, proton exchange membrane (PEM) electrolyzers appear as the most promising commercial systems for hydrogen production in the coming years. However, their massification is affected by the noble metals used as electrocatalysts in their electrodes, with high commercial value: Pt at the cathode where the hydrogen evolution reaction occurs (HER) and Ru/Ir at the anode where the oxygen evolution reaction (OER) happens. Therefore, to take full advantage of the PEM technology for green H2 production and build up a mature PEM market, it is imperative to search for more abundant, cheaper, and stable catalysts, reaching the highest possible activities at the lowest overpotential with the longest stability under the harsh acidic conditions of a PEM. In the search for new electrocatalysts and considering the predictions of a Trasatti volcano plot, rhenium appears to be a promising candidate for HER in acidic media. At the same time, recent studies provide evidence of its potential as an OER catalyst. However, some of these reports have focused on chemical and photochemical water splitting and have not always considered acidic media. This review summarizes rhenium-based electrocatalysts for water splitting under acidic conditions: i.e., potential candidates as cathode materials. In the various sections, we review the mechanism concepts of electrocatalysis, evaluation methods, and the different rhenium-based materials applied for the HER in acidic media. As rhenium is less common for the OER, we included a section about its use in chemical and photochemical water oxidation and as an electrocatalyst under basic conditions. Finally, concluding remarks and perspectives are given about rhenium for water splitting.
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This systematic review and reliability generalization meta-analysis synthesized psychometric literature on instrumentation assessing child-to-parent violence published through September 2023 across four databases. In the screening, we identified studies reporting Cronbach's alpha internal consistency estimates for the child-to-parent violence scales. The eligible reliability coefficients ranged from 0.610 to 0.930, mostly exceeding the minimum threshold of 0.700. Random-effects models calculated pooled Cronbach's alphas separately for global, father-specific, and mother-specific subscales. The results demonstrated cumulative values of 0.83 (global: standard error = 0.0129), 0.800 (fathers: standard error = 0.0203), and 0.81 (mothers: standard error = 0.0179), denoting largely adequate reliability. However, significant between-study heterogeneity was observed. While the mean alpha levels seem acceptable for most tools, substantial variability coupled with the possibility of some studies violating reliability assumptions indicates that a conservative interpretation is warranted. Ongoing scale refinement and additional psychometric evaluations will strengthen the rigor methodology in this developing research domain. However, these results should be interpreted with caution, as there is a high level of heterogeneity, and it is possible that some studies have not verified the assumptions underlying Cronbach's alpha.
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We describe the first case in our environment of endoscopic ultrasound (EUS)-assisted transgastric endoscopic retrograde cholangiopancreatography in a patient with gastric bypass surgery. The procedure was performed with a side-viewing duodenoscope through a jejunogastrostomy using apposing stents, placed with EUS assistance, and a standard technique and instruments.
Se describe el primer caso en nuestro medio de colangiopancreatografía retrógrada endoscópica transgástrica asistida por endosonografía en una paciente con cirugía de baipás gástrico. El procedimiento se realizó con duodenoscopio de visión lateral a través de una yeyunogastrostomía por stent de aposición, emplazado con asistencia endosonográfica y con una técnica e instrumental estándar.
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Background: Different prognostic scales exist in patients with brain metastasis, particularly in lung cancer. The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA index) for brain metastases is a powerful prognostic tool that effectively identifies patients at different risks. However, these scales do not include perilesional edema diameter (PED) associated with brain metastasis. Current evidence suggests that PED might compromise the delivery and efficacy of radiotherapy to treat BM. This study explored the association between radiotherapy efficacy, PED extent, and gross tumor diameter (GTD). Aim: The aim of this study was to evaluate the intracranial response (iORR), intracranial progression-free survival (iPFS), and overall survival (OS) according to the extent of PED and GT. Methods: Out of 114 patients with BM at baseline or throughout the disease, 65 were eligible for the response assessment. The GTD and PED sum were measured at BM diagnosis and after radiotherapy treatment. According to a receiver operating characteristic (ROC) curve analysis, cutoff values were set at 27 mm and 17 mm for PED and GT, respectively. Results: Minor PED was independently associated with a better iORR [78.8% vs. 50%, OR 3.71 (95% CI 1.26-10.99); p = 0.018] to brain radiotherapy. Median iPFS was significantly shorter in patients with major PED [6.9 vs. 11.8 months, HR 2.9 (95% CI 1.7-4.4); p < 0.001] independently of other prognostic variables like the Lung-molGPA and GTD. A major PED also negatively impacted the median OS [18.4 vs. 7.9 months, HR 2.1 (95% CI 1.4-3.3); p = 0.001]. Conclusion: Higher PED was associated with an increased risk of intracranial progression and a lesser probability of responding to brain radiotherapy in patients with metastatic lung cancer. We encourage prospective studies to confirm our findings.
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The widely used technology for the selective flotation of copper and molybdenite using sodium hydrosulfide (NaSH) to depress copper sulfides creates environmental issues related to the potential emissions of toxic hydrosulfide gas (H2S) and bad odors. Previous studies showed that molybdenite flotation can be depressed by the action of lignosulfonates, but no significant progress has been made in studying the effect that these reagents have on the foaming/frothing phenomena in flotation. The objective of this work was to investigate the foaming properties of three samples of lignosulfonates through measurements of surface tension, foamability, bubble size distributions, and water recovery. A sugared sodium lignosulfonate (NaLS), a calcium lignosulfonate (CaLS), and a sample prepared by sulphomethylation of kraft lignin (KLS) were tested. It was found that all lignosulfonates displayed surface activity that decreased with pH and was related to the degree of anionicity and molecular weight. The NaLS lignosulfonate showed the highest dynamic foamability index (DFI) value, compared to that of the CaLS and KLS samples. The lignosulfonates tested in this study strongly affected bubble size. Water recovery tests performed using flotation experiments in a two-phase system showed that the KLS and NaLS samples had the strongest effect, which correlated with the surface tension, foamability, and bubble size results.
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Lignocellulosic materials are usually processed toward C5 and C6 corresponding sugars. Trifluoroacetic acid (TFA) is a pretreatment method to solubilize hemicellulose to sugars such xylose without degrading cellulose. However, this pretreatment has not been compared to other processes. Thus, this paper focuses on the techno-economic comparison of the C5-C6 production of C5-C6 as raw materials platforms using non-centrifuged sugarcane bagasse (NCSB) and Pinus patula wood chips (PP). Hydrolysates using TFA 2.5 M as an acid were characterized through HPLC regarding arabinose, galactose glucose, xylose, and mannose sugars. Then, simulations of the processes according to the experimental results were done. The economic assessment was performed, and compared with some common pretreatments. The mass and energy balances of the simulations indicate that the process can be compared with other pretreatments. From the economic perspective, the main operating expenditures (OpEx) are related to raw materials and capital depreciation due to the cost of TFA corrosion issues. The processes showed a CapEx and OpEx of 0.99 MUSD and 6.59 M-USD/year for NCSB, and 0.97 MUSD and 4.37 MUSD/year for PP, considering a small-scale base (1 ton/h). TFA pretreatment is innovative and promising from a techno-economic perspective.
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OBJECTIVE: The objective is to compare the clinical and laboratory characteristics of systemic lupus erythematosus (SLE) patients with and without lupus enteritis (LE) and to identify the factors associated with the occurrence of LE. METHODS: We performed a retrospective, case-control study in hospitalized patients with SLE who were admitted to our tertiary hospital between January 2012 and December 2021. Sixteen LE patients (cases) were matched (1:3 ratio) for sex and birth year with 48 non-LE patients (controls). Univariable and multivariable logistic regression analyses were used to identify the variables associated with LE. RESULTS: Of 2,479 SLE patients who were admitted to our hospital as inpatients, 16 (0.65%) were diagnosed as having LE. All patients, cases and controls, were of Mestizo ethnicity. SLE was diagnosed simultaneously with the first episode of LE in 10 (62.5%) patients. The median time from SLE diagnosis to the first episode of LE was 7 (IQR 0-78) months. LE patients had a shorter median disease duration [7 (0-78) vs 34 (9.5-79) months], and a significantly longer hospital stay (28.3 ± 15.8 vs 6.5 ± 7.9 days, p < 0.001) than non-LE patients. Most LE patients (93.8%) had concomitant lupus nephritis. LE patients had higher SLEDAI-2K scores than those without LE (20.5 ± 9.4 vs 9.8 ± 10.4, p < 0.001). By multivariable analysis, a higher SLEDAI-2K score (OR 1.10, 95% CI 1.02-1.18; p = 0.015) was independently associated with LE occurrence after adjusting for cutaneous involvement, lymphocyte count, serum creatinine, and serum complement C4. Recurrence was observed in two patients (12.5%), both with a bowel wall thickening > 8 mm. The two patients with large intestine-dominant LE developed intestinal pseudo-obstruction. No patient had life-threatening complications (intestinal hemorrhage, infarction, or perforation), and there were no deaths induced directly by LE itself. CONCLUSION: In patients of Mestizo ethnicity, LE occurs during the early course of SLE, frequently is one of the presenting manifestations of SLE, and in most cases, it presents with concomitant lupus nephritis. Higher levels of disease activity at diagnosis were independently associated with LE occurrence and when recurrences occur, they do so in the context of severe wall thickness.
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Enteritis , Lupus Eritematoso Sistémico , Nefritis Lúpica , Humanos , Lupus Eritematoso Sistémico/diagnóstico , Nefritis Lúpica/epidemiología , Nefritis Lúpica/complicaciones , Estudios Retrospectivos , Estudios de Casos y Controles , América Latina , Enteritis/epidemiología , Enteritis/diagnósticoRESUMEN
Alopecia Areata (AA) is a multifactorial, dermatological disease characterized by non-scarring hair loss. Alterations in candidate genes, such as HR (Hairless), could represent a risk factor for its development. The aim of this study was to search for and analyze variants in exons 3, 15 and 17 of the HR gene in Mexican patients with AA. A total of 30 samples from both AA patients and healthy donors were analyzed in this study. Exons were amplified and sequenced using the Sanger method. Descriptive statistics and χ2 tests were used in the analysis of clinical-demographic characteristics and the comparison of allelic/genotypical frequencies between groups, respectively. The effect on protein function for the non-synonymous variants was determined with three bioinformatics servers. Three gene variants were identified in the HR gene of the evaluated patients. The benign polymorphism c.1010G > A p.(Gly337Asp) (rs12675375) had been previously reported, whereas the variants c.750G > A p.(Gln250Gln) and c.3215T > A (Val1072AGlu) have not been described in other world populations. Both non-synonymous variants proved to be significant (p ≤ 0.05). The variant c.3215T > A p.(Val1072Glu) is of particular interest due to its deleterious effect on the structure and function of the protein; therefore, it could be considered a risk factor for the development of AA.
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Bilateral index for upper limbs was determined for maximal force, speed and power in 18 male handball players. Variables were individually assessed with a functional electromechanical dynamometer during unilateral and bilateral bench press push-off for 40%, 60%, and 75% of the maximal isometric force. Limb dominance (symmetry indices) and load effects in the bilateral index were analysed. Bilateral index showed a bilateral deficit for power (range = -8.50 to -41.48) and velocity (range = -11.15 to -38.41), that increases with the load (p < 0.05). For maximum force, a bilateral facilitation (range = 2.26-5.57), which did not vary significantly as a function of load, was observed. Symmetry indices showed no association with the bilateral index (40% load: r = 0.45, 60% load: r = 0.05, 75% load: r = 0.39). These results contribute to understanding the phenomenon; however, individual-to-individual observation reflects that caution should be kept when assessing an individual athlete. In conclusion, bilateral deficit or facilitation for bench press depends on the variable considered, whereas its magnitude depends on the load. Moreover, limb dominance does not affect it. This finding must be regarded as a general trend, but a different situation may occur during the assessment of a particular athlete.
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Humanitarian crises can occur in places affected by chemical, physical, biological, and social threats, especially when these threats interact with each other and cause a syndemic. In order to avoid crises in these places, it is necessary to introduce mitigation measures that we have framed as "humanitarian scenarios". Due to their nature, implementation of these interventions requires the creation of multidisciplinary operational groups with a work strategy that integrates them into the affected community. In the case of the child population, the operational group was called the 'childhood risks in contaminated places' (CRCP) unit; contaminated places meaning localities impacted by chemical, physical, or biological threats. The strategy has six phases: (i) planning the survey and site visit; (ii) community involvement in identifying threats, vulnerabilities, and routes of exposure (the path of pollutants from their source to the receiving population), and in preparing joint work for the subsequent phases; iii) prioritization of risks identified through environmental monitoring and use of biomarkers of exposure and effects; iv) risk prevention through the creation of various 'capacities and alternatives for the prevention of syndemic threats'; (v) advocacy to implement these capacities and alternatives through risk communication and local training; and (vi) protection through measures that include telehealth, social progress, and innovation to improve health coverage. The strategy has been implemented in different contexts, and in some of them it has been enriched by analysis of respect for human rights.
Crises humanitárias podem ocorrer em locais afetados por ameaças químicas, físicas, biológicas e sociais, principalmente quando essas ameaças interagem entre si e causam uma sindemia. Para evitar as crises, é necessário introduzir nesses locais medidas de mitigação que enquadramos no termo "cenários humanitários". Por sua natureza, a implementação de tais ações de intervenção exige a formação de grupos operacionais multidisciplinares e de uma estratégia de trabalho que permita integrá-los à comunidade afetada. No caso da população infantil, o grupo operacional recebeu o nome de Unidade de Riscos Infantis em Áreas Contaminadas (na sigla em espanhol, RISC), ou seja, em locais impactados por ameaças químicas, físicas ou biológicas. A estratégia consiste nas seis fases a seguir: i) planejamento para o estudo e visita ao local; ii) participação da comunidade para identificar ameaças, vulnerabilidades e rotas de exposição (caminho que os contaminantes devem seguir desde a sua fonte até a população receptora), bem como para o trabalho conjunto nas fases seguintes; iii) priorização dos riscos identificados por meio do monitoramento ambiental e uso de biomarcadores de exposição e efeitos; iv) prevenção de riscos por meio da criação de diversas capacidades e alternativas para a prevenção diante de ameaças sindêmicas (CAPAS); v) promoção da implantação das CAPAS por meio da comunicação de riscos e capacitação local; e vi) proteção com medidas que incluem propostas de telessaúde, progresso social e inovação para melhorar a cobertura de saúde. A estratégia foi aplicada em diferentes contextos, em alguns dos quais foi enriquecida com uma análise do respeito pelos direitos humanos.
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The emergence of a polybasic cleavage motif for the protease furin in SARS-CoV-2 spike has been established as a major factor for human viral transmission. The region N-terminal to that motif is extensively mutated in variants of concern (VOCs). Besides furin, spikes from these variants appear to rely on other proteases for maturation, including TMPRSS2. Glycans near the cleavage site have raised questions about proteolytic processing and the consequences of variant-borne mutations. Here, we identify that sialic acid-containing O-linked glycans on Thr678 of SARS-CoV-2 spike influence furin and TMPRSS2 cleavage and posit O-linked glycosylation as a likely driving force for the emergence of VOC mutations. We provide direct evidence that the glycosyltransferase GalNAc-T1 primes glycosylation at Thr678 in the living cell, an event that is suppressed by mutations in the VOCs Alpha, Delta, and Omicron. We found that the sole incorporation of N-acetylgalactosamine did not impact furin activity in synthetic O-glycopeptides, but the presence of sialic acid reduced the furin rate by up to 65%. Similarly, O-glycosylation with a sialylated trisaccharide had a negative impact on TMPRSS2 cleavage. With a chemistry-centered approach, we substantiate O-glycosylation as a major determinant of spike maturation and propose disruption of O-glycosylation as a substantial driving force for VOC evolution.
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Severe Acute Respiratory Syndrome Coronavirus 2 is the causative agent of Coronavirus Disease 2019 in humans. Among domestic animals, cats are more susceptible to SARS-CoV-2 than dogs. The detection of anti-SARS-CoV-2 antibodies in seemingly healthy cats and/or infected cats which are in close contact with infected humans has been described. The presence of animals that tested positive by serology or molecular techniques could represent a potential transmission pathway of SARS-CoV-2 that can spill over into urban wildlife. This study analyses the seroprevalence variation of SARS-CoV-2 in stray cats from different waves of outbreaks in a geographical area where previous seroepidemiological information of SARS-CoV-2 was available and investigate if SARS-CoV-2-seropositive cats were exposed to other co-infections causing an immunosuppressive status and/or a chronic disease that could lead to a SARS-CoV-2 susceptibility. For this purpose, a total of 254 stray cats from Zaragoza (Spain) were included. This analysis was carried out by the enzyme-linked immunosorbent assay using the receptor binding domain of Spike antigen and confirmed by serum virus neutralization assay. The presence of co-infections including Toxoplasma gondii, Leishmania infantum, Dirofilaria immitis, feline calicivirus, feline herpesvirus type 1, feline leukemia virus and feline immunodeficiency virus, was evaluated using different serological methods. A seropositivity of 1.57% was observed for SARS-CoV-2 including the presence of neutralizing antibodies in three cats. None of the seropositive to SARS-CoV-2 cats were positive to feline coronavirus, however, four SARS-CoV-2-seropositive cats were also seropositive to other pathogens such as L. infantum, D. immitis and FIV (n = 1), L. infantum and D. immitis (n = 1) and L. infantum alone (n = 1).Considering other pathogens, a seroprevalence of 16.54% was detected for L. infantum, 30.31% for D. immitis, 13.78%, for T. gondii, 83.86% for feline calicivirus, 42.52% for feline herpesvirus type 1, 3.15% for FeLV and 7.87% for FIV.Our findings suggest that the epidemiological role of stray cats in SARS-CoV-2 transmission is scarce, and there is no increase in seropositivity during the different waves of COVID-19 outbreaks in this group of animals. Further epidemiological surveillances are necessary to determine the risk that other animals might possess even though stray cats do not seem to play a role in transmission.
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COVID-19 , Enfermedades de los Gatos , Coinfección , Dirofilaria immitis , Enfermedades de los Perros , Virus de la Inmunodeficiencia Felina , Humanos , Gatos , Animales , Perros , Enfermedades de los Gatos/epidemiología , SARS-CoV-2 , Coinfección/epidemiología , Coinfección/veterinaria , España/epidemiología , Estudios Seroepidemiológicos , Estudios Transversales , COVID-19/epidemiología , COVID-19/veterinaria , Virus de la Leucemia Felina , Brotes de Enfermedades , Enfermedades de los Perros/epidemiologíaRESUMEN
RESUMEN Las crisis humanitarias pueden presentarse en sitios afectados por amenazas químicas, físicas, biológicas y sociales, sobre todo cuando estas amenazas interaccionan entre sí y causan una sindemia. A fin de evitar las crisis, en estos sitios se hace necesario introducir medidas de mitigación que hemos enmarcado bajo el término de "escenarios humanitarios". Debido a su naturaleza, la implementación de dichas acciones de intervención requiere de la conformación de grupos operativos multidisciplinarios y de una estrategia de trabajo que permita integrarlos con la comunidad afectada. En el caso de la población infantil, el grupo operativo recibió el nombre de unidad de riesgos infantiles en sitios contaminados (RISC), es decir, en localidades impactadas por amenazas químicas, físicas o biológicas. La estrategia consta de las siguientes seis fases: i) planificación para el estudio y la visita al sitio; ii) participación de la comunidad para identificar amenazas, vulnerabilidades y rutas de exposición (el camino que deben seguir los contaminantes desde su fuente hasta la población receptora), así como para el trabajo conjunto en las siguientes fases; iii) priorización de riesgos identificados mediante el monitoreo ambiental y uso de biomarcadores de exposición y efectos; iv) prevención de riesgos a través de la creación de diversas capacidades y alternativas para la prevención ante amenazas sindémicas (CAPAS); v) promoción para implementar las CAPAS mediante la comunicación de riesgos y la capacitación local; y vi) protección con medidas que incluyen propuestas de telesalud, progreso social e innovación para mejorar la cobertura sanitaria. La estrategia ha sido aplicada en diferentes contextos, en algunos de los cuales, ha sido enriquecida con el análisis del respeto de los derechos humanos.
ABSTRACT Humanitarian crises can occur in places affected by chemical, physical, biological, and social threats, especially when these threats interact with each other and cause a syndemic. In order to avoid crises in these places, it is necessary to introduce mitigation measures that we have framed as "humanitarian scenarios". Due to their nature, implementation of these interventions requires the creation of multidisciplinary operational groups with a work strategy that integrates them into the affected community. In the case of the child population, the operational group was called the 'childhood risks in contaminated places' (CRCP) unit; contaminated places meaning localities impacted by chemical, physical, or biological threats. The strategy has six phases: (i) planning the survey and site visit; (ii) community involvement in identifying threats, vulnerabilities, and routes of exposure (the path of pollutants from their source to the receiving population), and in preparing joint work for the subsequent phases; iii) prioritization of risks identified through environmental monitoring and use of biomarkers of exposure and effects; iv) risk prevention through the creation of various 'capacities and alternatives for the prevention of syndemic threats'; (v) advocacy to implement these capacities and alternatives through risk communication and local training; and (vi) protection through measures that include telehealth, social progress, and innovation to improve health coverage. The strategy has been implemented in different contexts, and in some of them it has been enriched by analysis of respect for human rights.
RESUMO Crises humanitárias podem ocorrer em locais afetados por ameaças químicas, físicas, biológicas e sociais, principalmente quando essas ameaças interagem entre si e causam uma sindemia. Para evitar as crises, é necessário introduzir nesses locais medidas de mitigação que enquadramos no termo "cenários humanitários". Por sua natureza, a implementação de tais ações de intervenção exige a formação de grupos operacionais multidisciplinares e de uma estratégia de trabalho que permita integrá-los à comunidade afetada. No caso da população infantil, o grupo operacional recebeu o nome de Unidade de Riscos Infantis em Áreas Contaminadas (na sigla em espanhol, RISC), ou seja, em locais impactados por ameaças químicas, físicas ou biológicas. A estratégia consiste nas seis fases a seguir: i) planejamento para o estudo e visita ao local; ii) participação da comunidade para identificar ameaças, vulnerabilidades e rotas de exposição (caminho que os contaminantes devem seguir desde a sua fonte até a população receptora), bem como para o trabalho conjunto nas fases seguintes; iii) priorização dos riscos identificados por meio do monitoramento ambiental e uso de biomarcadores de exposição e efeitos; iv) prevenção de riscos por meio da criação de diversas capacidades e alternativas para a prevenção diante de ameaças sindêmicas (CAPAS); v) promoção da implantação das CAPAS por meio da comunicação de riscos e capacitação local; e vi) proteção com medidas que incluem propostas de telessaúde, progresso social e inovação para melhorar a cobertura de saúde. A estratégia foi aplicada em diferentes contextos, em alguns dos quais foi enriquecida com uma análise do respeito pelos direitos humanos.
Asunto(s)
Humanos , Niño , Sistemas de Socorro , Protección a la Infancia , Vulnerabilidad ante Desastres , Contaminantes Ambientales , Sindémico , Derecho a la SaludRESUMEN
Fundamento: la colaboración cubana demanda perfeccionar el dominio del idioma inglés entre aquellos profesionales de la salud que cumplen misiones internacionalistas. Objetivo: exponer los resultados de una estrategia metodológica para perfeccionar el dominio del idioma inglés en los profesionales de la salud que cumplen misiones internacionalistas. Métodos: se realizó un estudio descriptivo con diseño transversal en la Universidad de Ciencias Médicas de Villa Clara durante el período enero 2019 hasta junio 2021. Se aplicaron métodos teóricos, empíricos para la fundamentación de la investigación y recogida de información y matemático-estadísticos; la información obtenida se presentó en tablas con valores absolutos y relativos. Resultados: durante el año 2019 concluyeron 18 cursos, con 128 graduados, de ellos 61 con nivel A2. En el año 2020 culminó el Diplomado de Inglés para profesionales procedentes de Brasil con 55 participantes, la mayoría con nivel B1. También se graduaron 192 profesionales en cursos de inglés, el 63,54 % eran médicos, la mayoría de ellos especialistas en Medicina General Integral. Predominó el nivel B1 con 63 cursistas. Al concluir el mes de junio 2021 estaban participando en cursos de inglés 70 profesionales, la mayoría médicos (70.0 %) Conclusiones: se cumplió la capacitación programada para este periodo respondiendo a las necesidades de aprendizaje identificadas, se certificaron los graduados y se cumplimentaron los convenios de preparación a internacionalistas entre la Universidad de Ciencias Médicas Villa Clara y el Departamento Provincial de Colaboración.
Background: the Cuban collaboration demands improving the command of the English language among those health professionals who fulfill internationalist missions. Objective: to present the results of a methodological strategy to improve the command of the English language in health professionals who fulfill internationalist missions. Methods: a descriptive study with a cross-sectional design was carried out at Villa Clara University of Medical Sciences from January 2019 to June 2021. Theoretical and empirical methods were applied for the foundation of the research and information collection, and mathematical-statistical methods; the information obtained was presented in tables with absolute and relative values. Results: during the year 2019, 18 courses were completed, with 128 graduates, 61 of them with A2 level. In 2020, the Diploma in English for professionals from Brazil was completed with 55 participants, most with B1 level. 192 professionals also graduated in English courses, 63.54 % were doctors, most of them specialists in Comprehensive General Medicine. Level B1 predominated with 63 trainees. At the end of June 2021, 70 professionals were participating in English courses, most of them doctors (70.0 %) Conclusions: the training programmed for this period was fulfilled, responding to the identified learning needs, the graduates were certified and the internationalist preparation agreements between the Villa Clara University of Medical Sciences and the Provincial Department of Collaboration were fulfilled.
Asunto(s)
Estrategias de Salud , Educación Médica , Educación Profesional , Tutoría , Lenguaje , AprendizajeRESUMEN
Este estudio evalúa cómo los estudiantes incorporan el ChatGPT, una herramienta de inteligencia artificial, en sus hábitos de estudio, destacando la importancia de no verla como un sustituto absoluto en la obtención de resultados académicos precisos y convirtiéndonos en constantes validadores de la misma. Se centra en el análisis de las experiencias vividas por los estudiantes en el entorno académico de de una institución de educación superior durante el primer semestre de 2023. Se utilizó una encuesta estructurada para abordar dimensiones como la frecuencia de uso, la percepción de utilidad, la influencia en las dinámicas educativas y el nivel de satisfacción. Los resultados obtenidos en este estudio proporcionan una visión aproximada de cómo el ChatGPT impacta la calidad de la educación en este contexto específico, muestran que el 31,7% nunca ha utilizado ChatGPT para actividades académicas, mientras que el 68,3% lo ha utilizado, revelando cómo complementan su desarrollo académico. A pesar del desconocimiento inicial, la capacitación en el uso de ChatGPT generó una acogida positiva para optimizar los tiempos de estudio.
This study evaluates how students incorporate ChatGPT, an artificial intelligence tool, into their study habits, highlighting the importance of not viewing it as an absolute substitute in obtaining accurate academic results and becoming constant validators of it. It focuses on the analysis of the experiences lived by students in the academic environment of a higher education institution during the first semester of 2023. A structured survey was used to address dimensions such as frequency of use, perceived usefulness, influence on educational dynamics and level of satisfaction. The results obtained in this study provide an approximate view of how ChatGPT impacts the quality of education in this specific context, showing that 31.7% have never used ChatGPT for academic activities, while 68.3% have used it, revealing how it complements their academic development. Despite the initial lack of knowledge, training in the use of ChatGPT generated a positive reception to optimize study times.
Este estudo avalia a forma como os estudantes incorporam o ChatGPT, uma ferramenta de inteligência artificial, nos seus hábitos de estudo, destacando a importância de não o verem como um substituto absoluto na obtenção de resultados académicos precisos e de se tornarem constantes validadores do mesmo. Centra-se na análise das experiências dos estudantes no ambiente académico de uma instituição de ensino superior durante o primeiro semestre de 2023. Foi utilizado um inquérito estruturado para abordar dimensões como a frequência de utilização, a utilidade percebida, a influência na dinâmica educativa e o nível de satisfação. Os resultados obtidos neste estudo fornecem uma visão aproximada de como o ChatGPT impacta a qualidade da educação neste contexto específico, mostrando que 31,7% nunca utilizaram o ChatGPT para atividades académicas, enquanto 68,3% já o utilizaram, revelando como este complementa o seu desenvolvimento académico. Apesar da falta de conhecimento inicial, a formação na utilização do ChatGPT gerou uma receção positiva para otimizar os tempos de estudo.
Asunto(s)
HumanosRESUMEN
PURPOSE: Depression has become a major health concern, particularly in developing countries. This disorder is highly prevalent among certain vulnerable populations, such as prisoners. In Peru, prisons are overcrowded, and the health of prisoners is neglected. Thus, this study aims to estimate the prevalence of depression diagnosed during incarceration in male inmates from all Peruvian prisons and assess its associated factors. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study was conducted based on the secondary data analysis of the National Census of Prison Population 2016 in Peru. This study included records of prisoners who reported whether they were diagnosed with depression by a health-care professional after admission into the prisons. Descriptive, bivariate and multivariable analyses were performed. FINDINGS: Of the 63,312 prisoners included in this study, 1,007 reported an in-prison diagnosis of depression by a health-care professional, which represents a prevalence of 1.59%. Substance use disorder (adjusted prevalence ratio [aPR] 3.10; 95% confidence interval [CI]: 1.91-5.03), hypertension (aPR 7.20; 95% CI: 6.28-8.24) and previous discrimination (aPR 1.97; 95% CI: 1.62-2.40) were strongly associated with depression, even when adjusting for multiple confounders. Other directly associated variables were, for example, violence during childhood, infrequent visits in prison and diabetes. ORIGINALITY/VALUE: The right of prisoners to adequate health care is being neglected in Peru. Mental health is a cornerstone of health quality. Acknowledging which factors are associated with depression in prison is important to implement strategies to improve the mental health of prisoners.