Seguridad alimentaria y calidad de vida de la población en la provincia Cusco / Food security and quality of life the population in the Cusco Province / Segurança alimentar e qualidade de vida da população na província de Cusco

La seguridad alimentaria es cuando toda persona en todo momento tiene acceso económico y físico a suficientes alimentos inocuos y nutritivos para satisfacer sus necesidades alimentarias y preferencias en cuanto alimentos a fin de llevar una vida sana y activa. Por lo que el objetivo evaluar seguridad alimentaria y calidad de vida de la población vulnerable en la provincia Cusco, Perú. Para lo que se aplicó metodología con enfoque cuantitativo, con un diseño no experimental de corte transversal, basada en cuestionarios aplicados y entrevistas a una muestra de estudio (249 pobladores), la misma que previo a su aplicación superó las pruebas de validez y confiabilidad. Se realizó pruebas de frecuencia a los resultados de la opinión de los encuestados y correlación de Sperman's. Se evidencia que en un 65,9% la percepción de la población es que existe una inadecuada seguridad alimentaria, asimismo en un 85,1% que existe una mala calidad de vida, y desde una perspectiva estadística entre las citadas variables se obtuvo una significancia de 0,000 con un Rho de Sperman de 0,442, lo que demuestra la vulnerabilidad que se encuentra la población de Cusco. Concluyendo que entre las dos variables de estudio existe una relación directamente proporcional y de nivel moderado, denotando que en la media que se mejora los aspectos asociados a las dimensiones de la seguridad alimentaria, por consecuencia se tendría una mejora calidad de vida de la población de la provincia de Cusco, lo que evidencia que en la medida que se refuerce los aspectos asociados a la seguridad alimentaria, el bienestar físico y psicológico aspecto relacionado a la salud de dichas personas tendrá la oportunidad de mejorar.

Food security is when everyone at all times has economic and physical access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life. Therefore, the objective is to evaluate food security and quality of life of the vulnerable population in the province of Cusco, Peru. For which a methodology with a quantitative approach was applied, with a non-experimental cross-sectional design, based on questionnaires applied and interviews to a study sample (249 residents), which, prior to its application, passed the validity and reliability tests. Frequency tests were carried out on the results of the respondents' opinion and Sperman's correlation. It is evident that in 65.9% the perception of the population is that there is inadequate food security, also in 85.1% that there is a poor quality of life, and from a statistical perspective, a significance was obtained between the aforementioned variables of 0.000 with a Sperman's Rho of 0.442, which demonstrates the vulnerability of the population of Cusco. Concluding that between the two study variables there is a directly proportional relationship and of a moderate level, denoting that on average the aspects associated with the dimensions of food security are improved, consequently there would be an improved quality of life for the population of the province of Cusco, which shows that to the extent that the aspects associated with food security are reinforced, the physical and psychological well-being, an aspect related to the health of these people, will have the opportunity to improve

A segurança alimentar é quando todos têm, em todos os momentos, acesso económico e físico a alimentos seguros e nutritivos suficientes para satisfazer as suas necessidades dietéticas e preferências alimentares para levar uma vida saudável e activa. Portanto, o objetivo é avaliar a segurança alimentar e a qualidade de vida da população vulnerável na província de Cusco, Peru. Para o qual foi aplicada uma metodologia de abordagem quantitativa, com desenho transversal não experimental, baseada na aplicação de questionários e entrevistas a uma amostra do estudo (249 residentes), que, antes da sua aplicação, passou em testes de validade e fiabilidade. Foram realizados testes de frequência sobre os resultados das opiniões dos entrevistados e correlação de Spearman. Evidencia-se que em 65,9% a percepção da população é que há segurança alimentar inadequada, também em 85,1% que há má qualidade de vida, e do ponto de vista estatístico obteve-se significância entre as variáveis citadas de 0,000, com um Speman Rho de 0,442, o que demonstra a vulnerabilidade da população de Cusco. Concluindo que entre as duas variáveis do estudo existe uma relação diretamente proporcional e moderada, denotando que em média os aspectos associados às dimensões da segurança alimentar são melhorados, consequentemente haveria uma melhoria na qualidade de vida da população do província de Cusco, o que mostra que à medida que se reforçam os aspectos associados à segurança alimentar, o bem-estar físico e psicológico, aspecto relacionado à saúde dessas pessoas, terá a oportunidade de melhorar

Seguridad alimentaria y calidad de vida de la población en la provincia Cusco

La seguridad alimentaria es "cuando toda persona en todo momento tiene acceso económico y físico a suficientes alimentos inocuos y nutritivos para satisfacer sus necesidades alimentarias y preferencias en cuanto alimentos a fin de llevar una vida sana y activa". Por lo que el objetivo evaluar seguridad alimentaria y calidad de vida de la población vulnerable en la provincia Cusco, Perú. Para lo que se aplicó metodología con enfoque cuantitativo, con un diseño no experimental de corte transversal, basada en cuestionarios aplicados y entrevistas a una muestra de estudio (249 pobladores), la misma que previo a su aplicación superó las pruebas de validez y confiabilidad. Se realizó pruebas de frecuencia a los resultados de la opinión de los encuestados y correlación de Sperman's. Se evidencia que en un 65,9% la percepción de la población es que existe una inadecuada seguridad alimentaria, asimismo en un 85,1% que existe una mala calidad de vida, y desde una perspectiva estadística entre las citadas variables se obtuvo una significancia de 0,000 con un Rho de Sperman de 0,442, lo que demuestra la vulnerabilidad que se encuentra la población de Cusco. Concluyendo que entre las dos variables de estudio existe una relación directamente proporcional y de nivel moderado, denotando que en la media que se mejora los aspectos asociados a las dimensiones de la seguridad alimentaria, por consecuencia se tendría una mejora calidad de vida de la población de la provincia de Cusco, lo que evidencia que en la medida que se refuerce los aspectos asociados a la seguridad alimentaria, el bienestar físico y psicológico aspecto relacionado a la salud de dichas personas tendrá la oportunidad de mejorar.

Food security is "when everyone at all times has economic and physical access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life." Therefore, the objective is to evaluate food security and quality of life of the vulnerable population in the province of Cusco, Peru. For which a methodology with a quantitative approach was applied, with a non-experimental cross-sectional design, based on questionnaires applied and interviews to a study sample (249 residents), which, prior to its application, passed the validity and reliability tests. Frequency tests were carried out on the results of the respondents' opinion and Sperman's correlation. It is evident that in 65.9% the perception of the population is that there is inadequate food security, also in 85.1% that there is a poor quality of life, and from a statistical perspective, a significance was obtained between the aforementioned variables of 0.000 with a Sperman's Rho of 0.442, which demonstrates the vulnerability of the population of Cusco. Concluding that between the two study variables there is a directly proportional relationship and of a moderate level, denoting that on average the aspects associated with the dimensions of food security are improved, consequently there would be an improved quality of life for the population of the province of Cusco, which shows that to the extent that the aspects associated with food security are reinforced, the physical and psychological well-being, an aspect related to the health of these people, will have the opportunity to improve.

A segurança alimentar é "quando todos têm, em todos os momentos, acesso económico e físico a alimentos seguros e nutritivos suficientes para satisfazer as suas necessidades dietéticas e preferências alimentares para levar uma vida saudável e activa". Portanto, o objetivo é avaliar a segurança alimentar e a qualidade de vida da população vulnerável na província de Cusco, Peru. Para o qual foi aplicada uma metodologia de abordagem quantitativa, com desenho transversal não experimental, baseada na aplicação de questionários e entrevistas a uma amostra do estudo (249 residentes), que, antes da sua aplicação, passou em testes de validade e fiabilidade. Foram realizados testes de frequência sobre os resultados das opiniões dos entrevistados e correlação de Spearman. Evidencia-se que em 65,9% a percepção da população é que há segurança alimentar inadequada, também em 85,1% que há má qualidade de vida, e do ponto de vista estatístico obteve-se significância entre as variáveis citadas de 0,000, com um Speman Rho de 0,442, o que demonstra a vulnerabilidade da população de Cusco. Concluindo que entre as duas variáveis do estudo existe uma relação diretamente proporcional e moderada, denotando que em média os aspectos associados às dimensões da segurança alimentar são melhorados, consequentemente haveria uma melhoria na qualidade de vida da população do província de Cusco, o que mostra que à medida que se reforçam os aspectos associados à segurança alimentar, o bem-estar físico e psicológico, aspecto relacionado à saúde dessas pessoas, terá a oportunidade de melhorar.

Custos sociais da DPOC: o impacto sobre os anos de vida saudável e a perda de produtividade no Brasil entre os anos de 2017 e 2022 / Social costs of COPD: The impact on healthy life years and productivity loss in Brazil from 2017 to 2022

Objetivo: Estimar as perdas de produtividade causadas pela doença pulmonar obstrutiva crônica (DPOC) na população brasileira. Métodos: O estudo utilizou dados obtidos do Datasus, IBGE, indicadores previdenciários, óbitos e aposentadorias precoces por DPOC no Brasil de 2017 a 2022. Para estimar o impacto da DPOC, foram utilizados: anos de vida saudável perdidos (DALYs) e anos de vida ajustados por produtividade (PALYs), assim como as métricas de perda de produtividade salarial (PPS) e perda de produtividade nacionalizada (PPN), que avalia a perda em função do PIB. Resultados: Mais de 196 milhões de dias de trabalho foram perdidos devido à DPOC. As principais fontes são: óbitos precoces (95.264.088), afastamentos permanentes (67.314.232) e aposentadoria precoce (30.304.490). Diárias hospitalares (3.221.591) têm uma contribuição minoritária. O valor total de DALYs observado no período do estudo foi de 2.819.332,63 anos de vida saudável perdidos causados pela DPOC; um total de 14.997.166 PALYs foi perdido por conta da DPOC ou um valor anual equivalente de R$ 230,7 bilhões. Considerando a PPS, estimamos que a DPOC acarretou perdas de produtividade associadas à reposição da mão de obra de R$ 1,38 bilhão anual e, em relação à PPN, de R$ 8,28 bilhões por ano. Conclusões: Afastamentos de pacientes com DPOC podem acarretar maiores dispêndios com pagamentos de benefícios previdenciários. Este estudo atualiza e amplia correlações entre dados socioepidemiológicos, custos de saúde e previdenciários da DPOC no Brasil. Considerando todas as perdas, a DPOC pode causar perdas de R$ 240 bilhões por ano.

Objective: To estimate productivity losses due to workdays lost caused by chronic obstructive pulmonary disease (COPD) in the Brazilian population. Methods: The study used data from DATASUS, IBGE, social security indicators, deaths, and early retirements due to COPD in Brazil from 2017 to 2022. To estimate the impact of COPD, the following were used: Disability-Adjusted Life Years (DALYs) and Productivity-Adjusted Life Years (PALYs), as well as metrics for wage productivity loss (PPS) and nationalized productivity loss (PPN), which evaluates the loss in relation to GDP. Results: More than 196 million workdays were lost due to COPD. The main sources are premature deaths (95,264,088), permanent absences (67,314,232), and early retirement (30,304,490). Hospitalization days (3,221,591) had a minor contribution. The total DALYs observed during the study period was 2,819,332.63 years of healthy life lost due to COPD; a total of 14,997,166 PALYs were lost due to COPD, equivalent to an annual value of R$ 230.7 billion. Considering PPS, we estimate that COPD resulted in productivity losses associated with workforce replacement of R$ 1.38 billion annually; and in relation to PPN, R$ 8.28 billion per year. Conclusions: Absences in COPD patients can lead to higher expenditures on social security benefit payments. This is the first study to correlate socioepidemiological data, health, and social security costs of COPD in Brazil. Considering all losses, COPD can cause losses of R$ 240 billion per year.

Evolução do sobrepeso e obesidade no contexto dos países da OCDE e do Brasil / Evolution of overweight and obesity in the context of OECD countries and Brazil

Objetivo: A obesidade populacional afeta inúmeras nações do mundo, implicando custos econô¬micos, sociais e ambientais severos, comprometendo a condição de desenvolvimento sustentável. Este estudo tem como objetivo analisar a evolução da situação de sobrepeso e obesidade popu¬lacional dos países-membros da OCDE e do Brasil. Métodos: Este estudo analisa dados sobre a prevalência de sobrepeso e obesidade populacional disponibilizados pela OCDE para os seus paí¬ses-membros e pelo sistema Vigitel para o Brasil. Resultados: Os países da OCDE apresentam uma variabilidade grande na prevalência de sobrepeso/obesidade, e a prevalência média está na faixa dos 50%. Para o Brasil, a prevalência de sobrepeso e obesidade populacional aumentou expressiva¬mente nos últimos anos, indo de cerca de 45% em 2010 para 53,5% em 2020. Conclusão: A maioria dos países analisados está classificada em uma condição de taxa média de prevalência de sobrepeso e obesidade superior a 50% e uma tendência de crescimento dessa prevalência. O estudo ainda apresenta algumas ações e políticas públicas promovidas em outros países com o propósito de promover a redução da prevalência de sobrepeso e obesidade, e que poderiam ser adaptadas e implementadas no contexto brasileiro.

Objective: Population obesity affects many nations of the world, implying severe economic, social and environmental costs, compromising the condition of sustainable development. This study aims to analyze the evolution of the situation of overweight and obesity in the OECD member countries and Brazil. Methods: This study analyzes data on the prevalence of overweight and obesity made available by the OECD for its member countries, and by the Vigitel System for Brazil. Results: The OECD countries show a great variability in the prevalence of overweight/obesity, with the average prevalence being in the range of 50%. For Brazil, the prevalence of overweight and obesity in the population has increased significantly in recent years, going from about 45% in 2010 to 53.5% in 2020. Conclusion: Most of the countries analyzed are classified in a condition of average prevalence rate of overweight and obesity greater than 50% and a tendency for this prevalence to increase. The study also presents some actions and public policies promoted in other countries with the purpose of promoting the reduction of the prevalence of overweight and obesity, which could be adapted and implemented in the Brazilian context.

Ambiente alimentar em um território de vulnerabilidade social em Piraquara-PR / Food environment in a socially vulnerable territory in Piraquara-PR

RESUMO O ambiente alimentar é um conceito fundamental para compreender como o contexto social influencia os comportamentos alimentares. Ele se refere ao conjunto de fatores físicos, econômicos e sociais que afetam o acesso e a disponibilidade de alimentos em uma determinada região. O objetivo deste estudo foi avaliar o ambiente alimentar em uma região de vulnerabilidade social no município de Piraquara, região metropolitana de Curitiba-PR. O ambiente alimentar foi mapeado a partir de busca ativa, virtual e no território, de todo e qualquer dos 122 estabelecimentos de venda de alimentos nas áreas de abrangência das unidades de saúde. Constatou-se a predominância de estabelecimentos de alimentos não saudáveis (62,2%), pequeno número de estabelecimentos que comercializam alimentos saudáveis (9,8%) e alta concentração de qualquer tipo de estabelecimento no entorno de duas das principais vias da região, deixando grandes áreas com maior dificuldade de acesso. Nesse contexto, destaca-se a importância da criação de equipamentos de Segurança Alimentar e Nutricional no município que promovam a garantia de acesso físico e econômico a uma alimentação adequada e saudável para as famílias, especialmente em áreas de vulnerabilidade socioeconômica.

ABSTRACT The concept of the food environment plays a crucial role in comprehending how the social context influences eating behaviors. It encompasses a combination of physical, economic, and social factors that impact food access and availability within a specific region. This study aimed to assess the food environment in a socially vulnerable area within the municipality of Piraquara, located in the metropolitan region of Curitiba-PR. The food environment was charted through an active virtual search within the territories covered by health units, leading to the identification of 122 establishments. The analysis revealed a prevalence of unhealthy food vendors in the region (62.2%), a limited number of establishments offering healthy food options (9.8%), and a notable concentration of various types of establishments around two main roads, creating significant access challenges in other areas. In this context, the significance of establishing Food and Nutrition Security facilities in the municipality is underscored. Such initiatives aim to ensure both physical and economic access to suitable and nutritious food, particularly for families residing in socioeconomically vulnerable regions.

Percepción del clima organizacional y cultura de seguridad en el servicio de cirugía de un hospital de emergencias nivel III-1 / Perception of the organizational climate and safety culture in the surgery service of a level III-1 emergency hospital

RESUMEN Para determinar la correlación entre la percepción del clima organizacional y la cultura de seguridad en el servicio de cirugía del Hospital de Emergencias José Casimiro Ulloa (HEJCU), se realizó un estudio descriptivo y correlacional con 100 profesionales de salud, utilizando los cuestionarios ECO-S y MOSPS, respectivamente. La correlación se analizó con el coeficiente de correlación de Spearman, siendo p<0,05 estadísticamente significativo. Del total, 57% fueron hombres y 43% mujeres; 62% médicos y 38% enfermeros. El clima organizacional fue adecuado (43%), en riesgo (40%) e inadecuado (17%); la cultura de seguridad fue alta (14%), media (82%) y baja (4%). Se encontró una correlación positiva significativa entre la cultura de seguridad y el clima organizacional (rho=0,501), comportamiento organizacional (rho=0,477), estructura organizacional (rho=0,494) y estilo de dirección (rho=0,474) (p<0,001). En conclusión, existe una correlación positiva entre el clima organizacional y la cultura de seguridad en el servicio de cirugía del HEJCU.

ABSTRACT To determine the correlation between the perception of organizational climate and the safety culture in the surgery department of the José Casimiro Ulloa Emergency Hospital (HEJCU), a descriptive and correlational study was conducted with 100 healthcare professionals, using the ECO-S and MOSPS questionnaires, respectively. The correlation was analyzed using Spearman's correlation coefficient, with p<0.05 considered statistically significant. Of the total, 57% were men and 43% women; 62% were physicians and 38% nurses. The organizational climate was adequate (43%), at risk (40%), and inadequate (17%); the safety culture was high (14%), medium (82%), and low (4%). A significant positive correlation was found between safety culture and organizational climate (rho=0.501), organizational behavior (rho=0.477), organizational structure (rho=0.494), and management style (rho=0.474) (p<0.001). In conclusion, there is a positive correlation between organizational climate and safety culture in the surgery department of HEJCU.

Mortalidade por homicídio de policiais civis do estado da Bahia, Brasil / Mortality by murder of civil police officials in the state of Bahia, Brazil / Mortalidad por asesinato de policías civiles en el estado de Bahía, Brasil

Os homicídios de policiais estão associados a fatores individuais, sociais e do trabalho. Dessa forma, o objetivo deste artigo é caracterizar a mortalidade por homicídio de policiais civis da Bahia entre 2012 e 2019. Trata-se de estudo descritivo de vigilância da mortalidade de homicídios de policiais civis da ativa. As variáveis estudadas foram sociodemográficas, da atividade policial e da ocorrência. Na análise foram realizados cálculos de taxas de mortalidade e da estatística descritiva, por meio da linguagem computacional R versão 4.2.2. Foram registrados 27 homicídios de policiais civis da ativa, o que equivale a uma taxa média de 0,58/1000. Na caracterização, todos eram homens, com idade média de 52,5 anos (42 a 63 anos) e 95% negros. Em relação à atividade policial, 76% eram investigadores, com média de 17,9 anos (3 a 33 anos) de serviço e 81% das mortes ocorreram em horário de folga. Em 90% dos homicídios a arma de fogo foi o instrumento causador da morte, e em 62% dos casos a autoria não foi identificada. Conclui-se que o perfil sociodemográfico, do trabalho e das ocorrências de homicídios de policiais civis é semelhante ao perfil encontrado entre policiais militares e sobretudo aos homicídios da população geral.

Police homicides are associated with individual, social, and work-related factors. To characterize mortality due to homicide cases of civil police officers in the State of Bahia from 2012 to 2019.This is a descriptive study of mortality surveillance regarding the homicides of active civil police officers. The variables studied included sociodemographic, police activity, and event occurrence rates. In the analysis, mortality rates and descriptive statistics were calculated using the computational language R, version 4.2.2. Overall, 27 cases of homicide of civil police officers were registered, with an average rate of 0.58/1000 civil police officers. In the characterization, all victims were men with an average age of 52.5 years (42 to 63 years) and a 95% percent Black ethnicity. Regarding police activity, 76% were investigators, with an average of 17.9 years (3 to 33 years) of service, and 81% of deaths occurred during off-duty hours. In 90% of homicide cases, firearms were the instrument that caused death, and in 62% of cases the perpetrator was unidentified. The sociodemographic, work, and homicide profile of civil police officers resembles the profile among military police officers and especially that of homicides in the general population.

Los homicidios de policías están asociados a factores individuales, sociales y laborales. El objetivo de este artículo fue caracterizar la mortalidad por homicidio de policías civiles en el estado de Bahía (Brasil), en el período entre 2012 y 2019. Se trata de un estudio descriptivo de la vigilancia de la mortalidad por homicidios de policías civiles en activo. Las variables estudiadas fueron sociodemográficas, actividad policial y ocurrencia. En el análisis se realizaron cálculos de tasas de mortalidad y estadísticas descriptivas utilizando el lenguaje computacional R, versión 4.2.2.Se registraron 27 homicidios de policías civiles en activo, con una media de 0,58/1000 policías civiles. En la caracterización, todos eran hombres, con media de edad de 52,5 años (42 a 63 años), y el 95%, negros. Con relación a la actividad policial, el 76% se desempeñaban como investigadores, con un promedio de 17,9 años (3 a 33 años) de servicio y el 81% de las muertes ocurrieron fuera de servicio. En el 90% de los homicidios, el arma de fuego fue el instrumento que provocó la muerte y en el 62% de los casos no se identificó al autor. Se concluye que el perfil sociodemográfico, laboral y de homicidios de los policías civiles es similar al perfil encontrado entre los policías militares y, especialmente, a los homicidios en la población general.

Seguridad alimentaria y nutricional de niños menores de 5 años: de la dimensión alimentaria a la nutricional / Food and Nutrition Security of Children under 5 Years: From Food to Nutritional Dimension / Segurança alimentar e nutricional de crianças menores de 5 anos: da dimensão alimentar à nutricional

Objetivo: analizar la asociación de características biológicas y sociales con la seguridad alimentaria y nutricional (san) de niños menores de 5 años con base en indicadores de percepción del hambre y antro-pométricos.Materiales y métodos: estudio transversal realizado en municipios brasileños que fueron priorizados para el desarrollo de acciones de prevención de la obesidad infantil en 2017/2018. La san se midió usando la Escala Brasileña de Inseguridad Alimentaria y se utilizaron los índices antropométricos Talla/Edad (T/E), Peso/Edad (P/E) y Peso/Talla (P/T). Las asociaciones se testaron por regresión de Poisson con varianza robusta.Resultados: de los 868 niños, el 24.3 % vivía en familias con inseguridad alimenta-ria y nutricional moderada-severa (ianm-s), el 7.0 % tenía T/E baja; el 7.8 % P/E alto, y el 14.4 %, P/T alto. Si bien la ianm-s se asoció con una amplia gama de factores negativos del contexto social, las prevalencias de las desviaciones antropométricas fueron mayores en menores de 2 años y cuando las madres tenían el mismo diagnóstico nutricional que el niño.Conclusión: a pesar de las prevalencias expresivas de ianm-sy desviaciones antropométricas, la ianm-s fue más pronunciada, especialmente en contextos sociales des-favorables. La san mostró un comportamiento diferente en sus dimensiones alimentaria y nutricional, tanto en términos de frecuencia como de determinación

Objective: To analyze the association between biological and social characteristics with the food and nutritional security (fns) of children aged <5 years based on hunger perception and anthropometric indicators. Materials and methods: This cross-sectional study was performed at Brazilian municipali-ties that have been prioritized for the development of actions aimed at preventing childhood obesity in 2017­2018. The fns aspect was analyzed with reference to the Brazilian Food Insecurity Scale and the anthropometric indices Height/Age (H/A), Weight/Age (P/A), and Weight/Height (P/H) were used. The associations were tested by the Poisson Regression with robust variance. Results: Of the 868 children, 24.3 % lived in families with moderate­severe food and nutritional insecurity, 7.0 % had low H/A, 7.8 % had high P/A, and 14.4% had high P/E. The moderate­severe food and nutritional insecurity was associ-ated with a wide range of negative factors in the social context, but the prevalence of anthropometric deviations was higher in children <2 years and when their mothers had the same nutritional diagno-sis. Conclusion: Despite the expressive prevalence of moderate­severe food and nutritional insecurity and anthropometric deviations, the former was more pronounced, especially under unfavorable social contexts. san displayed different behaviors in its food and nutritional dimensions, both in the terms of frequency and determination.

Objetivo: analisar a associação de características biológicas e sociais com a Segurança Alimentar e Nutricional (san) de crianças menores de 5 anos com base em indicadores de percepção da fome e antropométricos. Materiais e métodos: estudo transversal realizado em municípios brasileiros que foram priorizados para o desenvolvimento de ações de prevenção da obesidade infantil em 2017/2018. A san foi medida usando a Escala Brasileira de Insegurança Alimentar e utilizaram-se os índices antropométricos Estatura/Idade (E/I), Peso/Idade (P/I) e Peso/Estatura (P/E). As associações se testaram por Regressão de Poisson com variância robusta. Resultados: das 868 crianças, 24.3 % residiam em famílias com Insegurança Alimentar e Nutricional Moderada-Grave (ianm-g), 7.0 % tinham E/I baixa, 7.8 % P/I elevado e 14.4 % P/E elevado. Enquanto a ianm-gassociou-se a uma ampla gama de fatores negativos do contexto social, as prevalências dos desvios antropo-métricos foram maiores em menores de 2 anos e quando as mães tiveram o mesmo diagnóstico nutricional que a criança. Conclusão: apesar das prevalências expressivas de ianm-g e de desvios antropométricos, a ianm-gfoi mais acentuada, sobretudo em contextos sociais desfavoráveis. A san manifestou comportamento dife-rente nas suas dimensões alimentar e nutricional, tanto em termos de frequência quanto de determinação.

Ciberseguridad en servicios de apoyo al médico ocupacional de la ciudad de Lima. Estudio piloto / Cybersecurity in the support services to occupational physicians in the city of Lima. A pilot study

RESUMEN Recientes investigaciones destacan la importancia de la ciberseguridad en la creciente era digital. El 83% de las organizaciones han experimentado brechas de seguridad en el 2022, costándoles en promedio 4,35 millones de dólares americanos por incidente. En Perú, la ciberseguridad está regulada por diversas normas, estableciendo medidas de protección de datos y la seguridad informática. Objetivo Describir la situación de la ciberseguridad en los servicios de apoyo al médico ocupacional (SAMO). Material y métodos Se incluyeron 11 SAMO. Se elaboró un cuestionario no validado para recolectar la información consentida sobre la gestión de la ciberseguridad de los SAMO que brindaban servicio a un importante proyecto de construcción en Lima Metropolitana. Resultados La mayoría de los establecimientos de salud (más del 80%) tuvo planes de respuesta a incidentes de seguridad cibernética para garantizar una respuesta rápida ante un ataque cibernético; realizaban copias de seguridad de los datos críticos con regularidad y los almacenaban en un lugar diferente a establecimiento; y actualizaban regularmente los sistemas operativos y programas de softwares buscando asegurar que se utilizan versiones seguras. Conclusión Existe una gestión de la seguridad informática predominantemente reactiva. El reporte discute la importancia de la ciberseguridad, resaltando la exposición de la información médica y los servicios a riesgos cibernéticos y planteamos retos futuros para la ciberseguridad, subrayando la importancia de la preparación ante amenazas futuras en un entorno en constante transformación digital.

SUMMARY Recent investigations emphasize the importance of cybersecurity in the growing digital era; 83% of organizations experienced breaks in cyber security in 2022, spending a mean of 4,35 million dollars per incident. Cybersecurity in Peru is regulated by legal norms aimed at protecting data and providing informatic security. Objective To describe cybersecurity in the support services to occupational physicians (SSOP) in the city of Lima. Methods A non-validated survey was created and distributed to 11 SSOPs in Lima that provide a service to an important building project in Lima. Results More than 80% of health care establishments had a response plan against cybernetic attacks; security copies of the data were done regularly storing them in a different place than the establishment and regularly updated security software's. Conclusion The cybersecurity program is reactive. We discuss the importance of cybersecurity and analyze future challenges as well as emphasize the importance of preemptive preparedness in an environment of constant digital transformation.

Research on Financial Security for Rural Public Health Service Personnel Talent/ / 中国卫生经济

The quantity and quality of rural public health service personnel are crucial for ensuring the health of rural residents.However,there are current challenges including insufficient personnel quantity and professional competence,severe talent loss,and low levels of rural public health services.The main reasons behind these challenges include insufficient financial investment,an imperfect salary system,inadequate performance evaluation mechanisms,and uneven resource allocation.In 2023,the National Health Commission and other departments jointly initiated anti-corruption efforts in the medical field while deepening healthcare system reforms.These reforms focus on strengthening the public health system,especially in rural and community areas,and revamping grassroots salary structures with an emphasis on decoupling salaries from revenue generation.However,specific measures for financial security of rural health personnel have not been clearly outlined.To bring in and retain rural health personnel,the financial security mechanism needs to be improved.It is recommended to increase financial investment by expanding budget allocations,implement a"dossier system"with salaries paid directly to individuals'accounts from municipal or county-level budgets,refine the salary system,reform performance evaluation mechanisms,raise overall remuneration,rationalize the allocation of resources,enrich health talents and encourage retired doctors to settle in rural areas.By gradually improving the financial security mechanism for rural public health service personnel,sustainable development of rural public health services can be achieved.

The conceptual definition,development dilemma,and path selection of a multi-level healthcare security system under the perspective of holistic governance / 中国卫生政策研究

The unclear connotation and fragmented governance of the multi-tiered medical security system pose challenges to its high-quality development.This article redefines the concept and connotation of the multi-tiered medical security system using holistic governance theory.It distinguishes the bottom layer,basic layer,and supplementary layer from the perspective of the essential attributes and direct functions of each system.Furthermore,from the perspective of holistic governance,the article analyzes the current reform practice and finds that fragmented management thinking,unclear positioning of sub-system functions,insufficient policy coordination,single participation subject,and lack of equal negotiation mechanisms are constraints on the overall effectiveness of the multi-tiered medical security system.Therefore,it is necessary to adopt systematic and targeted reform measures from the perspective of holistic governance to improve the system.

Clinical safety and validity analysis of retrograde new endo-scopic visual field in miniature pigs / 中国现代普通外科进展

Objective:To study the clinical safety and validity of retrograde new endoscopic field of vision in miniature pigs.Methods:6 live miniature pigs were selected as study subjects,En-doscopic Retrograde New View(ERNV)was selected.The performance,image quality and intraoper-ative and postoperative complications were evaluated.To evaluate whether all the experimental ani-mals could complete the relevant endoscopy.Verify ERNV's operating performance,including whether the duodenoscope can enter the biliary tract smoothly,and made sure whether the injection,suction,and instrument channels were unobstructed.Choledochoscope image clarity,color resolu-tion,image deformation and distortion,accurate evaluation of lumen conditions and clear observation of mucosal surface conditions were analyzed.Whether there were operant injuries such as bleeding and perforation,as well as adverse events such as respiratory depression and cardiac arrest.The sur-vival status and adverse reactions of all pigs were observed.Results:The choledochoscope was successfully inserted into the bile duct of 6 miniature pigs.The product had good operation perfor-mance and could enter the bile duct through the duodenoscope smoothly.The injection,suction and instrument channels were relatively smooth.In addition,the endoscopic images are clear,with better color resolution,and without image deformation and distortion,which can realize accurate evaluation of the conditions in the lumen and observe the mucosal surface conditions more clearly.No bile duct stenosis or dilatation occurred in all miniature pigs,and the bile duct mucosa was smooth,without hyperemia and edema,and no abnormal thickening or bending of mucous vessels.During the exami-nation,there were no operational injuries such as bleeding and perforation,and no adverse events such as respiratory depression and cardiac arrest occurred.The vital signs of all miniature pigs tended to be stable after operation,and the survival state was good,and there were no complications such as cholangitis,bleeding and perforation.Conclusion:ERNV has good clinical safety and efficacy,ex-cellent operation performance and excellent image quality,and is worthy of clinical application.

Effects of bunched cognitive behavior intervention on disease fear and psychological security in glioma patients / 中华行为医学与脑科学杂志

Objective:To investigate the effects of bunched cognitive behavior intervention on disease fear and psychological security in patients with glioma.Methods:A total of 92 patients with glioma who underwent surgical treatment from January 2022 to June 2023 were selected.According to the order of enrollment, all subjects were divided into research group( n=44)and control group( n=48). The patients in control group received routine medical and nursing intervention, and patients the research group adopted glioma bunched cognitive behavior intervention on the basis of routine medical and nursing intervention, including 4 intervention cycles.At enrollment, 2 weeks after intervention, and 4 weeks after intervention, all subjects were evaluated by the fear of progression questionnaire-short form (FoP-Q-SF), safety questionnaire (SQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). All the data in this study were processed by SPSS 26.0 statistical software.The scores of FoP-Q-SF, SQ, SAS and SDS before and after intervention were compared by repeated measures ANOVA between the two groups. Results:(1)The total FoP-Q-SF score, physiological health dimension scores, and social family dimension scores of the two groups showed significant interaction effects before and after intervention ( F=254.839, 52.738, 12.237, all P<0.05). Further simple effect analysis showed that after 2 and 4 weeks of intervention, the FoP-Q-SF scores of the research group (2 weeks after intervention: 33.80±4.94, 36.48±4.04; 4 weeks after intervention: 31.25±4.55, 35.94±4.47) and social family dimensions (2 weeks after intervention: 15.32±2.56 points, 17.06±2.14; 4 weeks after intervention: 14.05±2.59, 16.96±1.99) were lower than those of the control group (all P<0.05). The physiological health dimension score of the research group was lower than that of the control group after 4 weeks of intervention (4 weeks after intervention: 17.30±2.92, 19.06±2.38) ( P<0.05). After 4 weeks of intervention, the FoP-Q-SF score, physiological health dimension score, and social family dimension score of the research group were all lower than those at 2 weeks after intervention and before intervention (all P<0.05). (2)The total SQ score, interpersonal security dimension score and the determined control score of the two groups showed significant interaction effects before and after intervention( F=193.129, 54.706, 44.015, all P<0.05). Further simple effect testing showed that after 2 and 4 weeks of intervention, the total SQ score and interpersonal security score of the research group were higher than those of the control group (all P<0.05). The determined control score of the research group was higher than that of the control group after 4 weeks of intervention ( P<0.05). After 2 and 4 weeks of intervention, the total SQ score, interpersonal security score, and determination control score of the research group were higher than before intervention (all P<0.05), and the total SQ score and interpersonal security score of the research group were higher than 2 weeks after intervention (both P<0.05). (3)The SAS score and SDS score of the two groups showed significant interaction effects before and after intervention( F=237.867, 282.882, both P<0.05). Further simple effect analysis showed that after 2 and 4 weeks intervention, the SAS and SDS scores of the research group were lower than those of the control group (all P<0.05). The SAS and SDS scores of the research group were lower after 2 weeks and 4 weeks intervention than before intervention (all P<0.05). The SAS and SDS scores of the research group at 4 weeks after intervention were lower than those at 2 weeks after intervention (both P<0.05). Conclusion:Bundled cognitive behavioral intervention can improve disease fear and negative emotions in patients with glioma, and enhance psychological security.

Ethical risks and countermeasures of brain-computer interface technology / 中国医学伦理学

In the field of ethics,issues related to brain-computer interface(BCI)technology mainly focus on physical and mental ethics,as well as social ethics,including personal privacy rights,whether a person is a person in the complete sense,the attribution of social responsibility.The population involved includes patients,doctors,and the whole social group in which patients live.In addition to analyzing physical and mental ethical risks,this paper also analyzed the potential ethical issues that may exist in the future large-scale application of BCI based on the current research status,mainly including the right of informed consent,privacy,and decision-making of physical and mental ethical risks,the responsibility attribution and fairness of social ethical risks,the responsibility ascription and equity of social ethical risk,and the question that whether the brain is the carrier of machine or the machine is the continuation of the brain in future ethical risks.Solutions have been proposed in the three levels of individual,system,and institution to provide governance recommendations for the future development of BCI.In addition,local data was obtained by collecting and summarizing relevant opinions through social research.Based on these,the future risks of BCI were introduced for the first time,and from the perspective of ethics,solutions to future problems were explored.

Acromegaly with pregnancy: A case report and review of literature / 中华内分泌代谢杂志

This article reports the diagnosis and treatment of a case of acromegaly in a pregnant patient who took bromocriptine during pregnancy and delivered successfully. A retrospective summary of the clinical data and treatment outcomes before and after two pregnancies of the patient is provided. The patient took bromocriptine during the second pregnancy, and her condition remained stable. A baby girl was delivered by caesarean section at full term. The article suggests that pregnancy in acromegaly patients, after the stabilization of the condition, can lead to favorable outcomes. The use of dopamine receptor agonists during pregnancy does not increase adverse events during the perinatal period.

Efficacy and safety of a gastric bypass stent system for the treatment of obesity / 中华消化内镜杂志

Objective:To evaluate the efficacy and safety of a gastric bypass stent system for weight loss and obesity-associated metabolic parameters.Methods:A sub-analysis of a multicenter randomized control trial was conducted on data of 14 obese patients who were implanted the gastric bypass stent system under endoscopy in Beijing Friendship Hospital, Capital Medical University from March 2021 to October 2022. The device was removed after 12 weeks and the patients were followed up for 36 weeks. Outcomes included changes in excess weight loss (EWL), total weight loss (TWL), insulin resistance, liver enzymes, lipids and uric acid at 12, 24 and 36 weeks, and the safety of the device.Results:Among the 14 patients, there were 9 males and 5 females, aged 34.3±7.4 years, with an initial body weight of 104.8±13.9 kg. Stents were removed in advance in 2 patients because of intolerable adverse reactions of the digestive tract. The remaining 12 patients completed follow-up, and their EWL was 34.4%±25.5% at 12 weeks, 39.1%±37.5% at 24 weeks, and 27.3%±40.8% at 36 weeks. TWL was 8.7%±6.2%, 10.1%±10.2% and 8.3%±13.8%, respectively. The levels of homeostasis model assessment of insulin resistance (HOMA-IR) at 12 weeks (4.81±3.71, P=0.022), 24 weeks (4.17±2.77, P=0.002) and 36 weeks (4.66±3.58, P=0.016) were statistically significant compared with baseline (7.03±3.59). The levels of alanine aminotransferase (ALT) were 48 (21-124) U/L, 39 (14-96) U/L, 27 (10-86) U/L and 32 (16-113) U/L at baseline, 12 weeks, 24 weeks and 36 weeks, respectively, and the changes of ALT were statistically significant at 24 weeks and 36 weeks ( P=0.009, P=0.026 compared with baseline). The levels of aspartate aminotransferase (AST) were 30 (20-62) U/L, 24 (15-72) U/L, 22 (11-56) U/L and 26 (13-74) U/L at baseline, 12 weeks, 24 weeks and 36 weeks, respectively, and the change of AST was significant at 24 weeks ( P=0.018 compared with baseline). However, the changes of uric acid and serum lipid were not statistically significant ( P>0.05). The only severe adverse event was esophageal mucosal laceration during the process of explantation, which was successfully treated with endoscopic clips. There was no device migration, acute pancreatitis or hepatic abscess. Conclusion:The gastric bypass stent system, relatively safe, has a good short-term weight loss effect and improves insulin resistance and liver enzymes.

Construction and operation of the multi-level medical security system of the West China Women and Children Alliance / 中华医院管理杂志

Medical mutual aid is an important component of multi-level medical security system. West China Second University Hospital of Sichuan University led the establishment of the pediatric specialty alliance " West China Women and Children Alliance". Based on customized and inclusive mutual insurance product " Family Doctor Mutual Aid Plan", the alliance implemented key links such as mutual aid product forms, patient risk protection, institutional financing and hematopoiesis, and distribution of benefits to all parties, explored innovative mutual aid funding, payment, and incentive mechanisms, forming a closed-loop pediatric tiered diagnosis and treatment service system with the Mutual Aid Plan as the core. This system operated continuously under the " Four-in-One" framework, stimulating the integration of medical insurance and service supply systems while enhancing the synergistic effect between mutual insurance and social security. It has formed a distinctive health-centered multi-level medical security system within the alliance, and could provide reference for the construction and exploration of hierarchical diagnosis and treatment system.

Impact of the sense of security on interpersonal relationships among impoverished college students / 中国学校卫生

Objective@#To explore the impact of the sense of security on interpersonal relationships among impoverished college students, so as to provide empirical evidence for effective interpersonal communication cirsis prevention among impoverished college students.@*Methods@#In March 2023, a stratified random sampling method was used to select one university from Shanghai, Jiangsu, Henan, Anhui, Inner Mongolia, Gansu, Guangxi respatively. A total of 1 687 impoverished college students from 7 universities were surveyed using the Sense of Security Scale, Interpersonal Relationship Comprehensive Diagnosis Scale, Stress Perception Scale (SPS), and Mindfulness Attention Awareness Scale (MAAS). Moderated mediation effect analysis was performed using Model 7 in the SPSS macro program PROCESS.@*Results@#There was significant gender differences in the sense of security among impoverished college students (t=-2.31，P<0.05), and significant difference in interpersonal relationships by grade was observed (F=3.60，P<0.05). A sense of security was negatively associated with difficulties in interpersonal relationships among impoverished college students (β=-0.17, t=-9.27, P<0.01). Psychological stress partially mediates the relationship between the two, accounting for 19.54% of the total effect. Mindfulness regulates the first half of the path (β=0.10, t=5.32, P<0.01).@*Conclusions@#The sense of security shows impacts on interpersonal relationships among impoverished college students through psychological pressure. And it strengthens with the improvement of mindfulness level. Attention should be paid to cultivating a sense of security among impoverished college students, improving their level of mindfulness, and preventing interpersonal crisis due to excessive psychological pressure.

Health impact assessment of the development of employment and social security in Deqing County， Zhejiang Province / 上海预防医学

ObjectiveTo identify the possible health impact of the 14th five⁃year plan for the development of employment and social security in Deqing County and propose improvement measures through health impact assessment. MethodsBased on the data of Deqing County， stakeholder interviews and Delphi Consultation Method， this study described the current status of employment and social security and analyzed the potential health impacts of implementing the 14th five⁃year plan for the development of employment and social security in Deqing County. ResultsThrough a quick assessment process， the results showed that the implementation of the plan would bring mixed health impacts. Positive impacts included enhanced social security capacity， improved health levels of low-income populations and families， increased convenience of medical treatment， and improved efficiency of health services. Negative impacts included reduced accessibility of digital services for the elderly， increased gap in benefits for retirees， increased risk of discrimination against disabled individuals， increased risks of layoffs and unemployment for vulnerable groups， and increased employment instability for middle-aged and elderly populations. ConclusionThe 14th five⁃year plan for the development of employment and social security in Deqing County will bring a series of positive health impacts， but negative health impacts also warrant attention.

Medical emergency support for the snowboarding project during the Beijing Winter Olympics / 北京大学学报(医学版)

Objective:To analyze and summarize the medical security situation of the snowmobile,sled,and steel frame snowmobile tracks at the National Sliding Centre,and to provide experience for future event hosting and medical security work for mass ice and snow sports.Methods:Retrospective analysis of injuries and treatment of athletes participating in the International Training Week and World Cup for Ski,Sled,and Steel Frame Ski from October to November 2021(hereinafter referred to as"Inter-national Training Week"),as well as the Ski,Sled,and Steel Frame Ski events at the Beijing Winter Olympics in February 2022(hereinafter referred to as the"Beijing Winter Olympics").We referred to and drew on the"Medical Security Standards for Winter Snow Sports"to develop specific classification standards for analyzing injured areas,types of injuries,and accident locations.Results:A total of 743 athletes participated in the International Training Week and the Beijing Winter Olympics.During the com-petition,there were 58 incidents of overturning,prying,and collision,of which 28(28 athletes)were in-jured,accounting for 48.3％of the total accidents and 3.8％of the total number of athletes.Among them,there were 9 males(32.1％)and 19 females(67.9％),with an average age of(26.3±4.7)years.Among the 28 injured athletes,20 cases(71.4％)received on-site treatment for Class Ⅰ injuries,while 8 cases(28.6％)had more severe injuries,including Class Ⅱ injuries(7 cases)and Class Ⅲ injuries(1 case),which were referred to designated hospitals for further treatment.Among the 28 injured athletes,3 cases(10.7％)experienced multiple injuries,including 2 cases of 2 injuries and 1 case of 3 injuries.The most common injuries were in the ankle and toes(10/32,31.3％).Out of 28 injured athletes,one(3.6％)experienced two types of injuries simultaneously,with joint and/or ligament injuries being the most common(11/29,37.9％).The most accident prone point on the track was the ninth curve(18/58,31.0％).Conclusion:Through the analysis and summary of medical security work,it can provide better experience and reference for the future development of snowmobile,sled,and steel frame snowmobile sports in China,making the National Snowy and Ski Center truly a sustainable Olympic heritage.