The Environmental Impact Assessment of Sanitation Projects in Chile: Overview and Improvement Opportunities Focused on Follow-Ups.

The Environmental Impact Assessment (EIA) is a legal and administrative tool aimed to identify, predict, and interpret the impact of a project or activity on the environment and human health. The EIA also evaluates the accuracy of the predictions and audits the effectiveness of the established preventive measures. Regarding the sanitation sector, efficiency of wastewater treatments and sanitation networks determine the pollutant level of the discharged liquid effluents and the subsequent impact on the environment and human health. This problematic makes necessary to assess how proper the regulatory follow-ups of sanitation projects is. This paper evaluates the performance of the Chilean EIA System concerning to sanitation projects. Taking into account that the more restrictive Environmental Impact Study (EIS) and more permissive Environmental Impact Declaration (EID) are the ways for projects' entry to the EIA System in Chile, 5336 sanitation projects submitted to EIA between 1994 and 2019 were complied. A representative sample of 76 projects (15 entered as EIS and 61 as EID) was analyzed by using a principal coordinate analysis (PCoA) through 14 selected performance indicators. Observed weaknesses have led to propose improvement opportunities of the EIA focused on the follow-ups after the environmental license is obtained, such as creation of a simplified sanctioning procedure, decentralization of decision-making, deadline establishment in each stage, and unified direct link for each project. These proposals seek to improve the effectiveness of monitoring and possible sanctions to early identify impacts of sanitation projects on the environment and human health. This paper introduces a robust methodology for evaluation criteria focused on the follow-ups analysis, which can be used in other countries that consider respectful sanitation projects have direct social and environmental benefits leading to long-term indirect cultural and economic values.

El cribado de cáncer de mama a examen / Breast cancer screening under scrutiny

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Evidencias para el uso de antiinflamatorios no esteroideos tópicos / Evidence for the use of topical non-steroidal anti-inflammatory drugs

OBJETIVO. Analizar la eficacia de los AINE tópicos en pacientes con dolor osteomuscular agudo y crónico. MÉTODO. Análisis de la evidencia disponible. Búsqueda bibliográfica (Septiembre. -2013) en Medline/PubMed, WOK y Cochrane Library. Palabras clave: "NSAIDs", "topical administration", "acute pain", "chronic pain". RESULTADOS Y CONCLUSIONES. Se analizaron 9 revisiones sistemáticas y 4 meta-análisis, llegando a las siguientes conclusiones: · Los AINE tópicos proporcionan analgesia por el mismo mecanismo de acción que los AINE orales, pero su actividad efectiva sucede principalmente en el lugar de aplicación, y la exposición sistémica al AINE es sustancialmente menor que con los AINE orales. • Existen evidencias de máximo nivel para recomendar el uso de algunos AINE tópicos en el tratamiento del dolor osteomuscular agudo leve o moderado (contusiones, esguinces y torceduras),durante una semana. • Existen evidencias de máximo nivel para recomendar el uso de algunos AINE tópicos en el tratamiento del dolor osteomuscular crónico localizado, en pacientes con artrosis de rodilla y de mano, durante períodos de tiempo limitados (2-8 semanas). • No hay evidencias suficientes para recomendar su uso en lumbalgias, dolor extenso o enartrosis de cadera. • Los AINE tópicos para los que existe más y mejor evidencia son ibuprofeno, ketoprofeno y sobre todo diclofenaco

OBJECTIVE. To analyse the efficiency of topical non-steroidal anti-inflammatory drugs (NSAIDs) in patients suffering from acute and chronic osteomuscular pain. METHOD. Analysis of available evidence. Literature search (September 2013) in Medline/Pub-Med, WOK and Cochrane Library. Key words: "NSAIDs", "topical administration", "acute pain", "chronic pain". RESULTS AND CONCLUSIONS. Nine systematic reviews and four meta-analyses were analysed, with the following conclusions: • Topical NSAIDs afforded analgesia by the same acting mechanism as oral NSAIDs, but their effective activity takes place mainly at the site of application, and systematic exposure to the NSAID is substantially lower than with oral NSAIDs. • Top level evidence exists to recommend the use of some topical NSAIDs in the treatment of mild or moderate acute osteomuscular pain (contusions, sprains and twists) for one week. • Top level evidence exists to recommend the use of some topical NSAIDs in the treatment of local chronic osteomuscular pain in patients with osteoarthritis of the knee and of the hand for limited periods of time (2-8 weeks). • There is insufficient evidence to recommend its use for lumbago, widespread pain or osteoarthritis of the hip. • Topical NSAIDs for which there is more extensive and better evidence are ibuprofen, Ketoprofen and especially diclofenac