Survey on sanitary practices and knowledge about infectious diseases among equine owners in the State of Rio Grande do Norte, Brazil.

As the primary decision-maker about the health, nutrition, and well-being of their horses, owners' knowledge of correct management practices and clinical changes can potentially affect the immediate health of their horses, in addition to having an impact on the prevention of disease spread in the herd. The adoption of management practices to prevent the introduction and spread of pathogens depends on various factors, including demographics, awareness of the problem, perceived responsibility, previously held beliefs, and sociocultural norms. This study aimed to evaluate the health management practices and the level of knowledge about infectious diseases of equine owners in the state of Rio Grande do Norte, Brazil. A cross-sectional study was conducted by distributing a questionnaire to horse owners in Rio Grande do Norte, Brazil. The participants included horse owners irrespective of the duration of ownership, experience, or sports practiced. In addition to the hygiene and management of animals, the questionnaire addressed topics related to the facilities where the horses were kept. Three hundred and two horse owners distributed in 60 of the 167 municipalities in the state of Rio Grande do Norte participated in this study. Among the interviewed owners, 63.90% (193/302) answered that they do not quarantine animals introduced into the herd or those visiting the property. Regarding the deworming program, 95.03% (287/302) of the owners regularly dewormed their animals. However, more than half of the participants sought veterinary guidance (54.30%). Investing in educational programs and increasing the awareness of equine owners in the state of Rio Grande do Norte about the main infectious diseases in horses is essential toward improving sanitary management and the general health of animals. Informed owners play an essential role in creating safer environments for their horses, thereby contributing to the sustainability of the equine industry.

Como principal tomador de decisão sobre a saúde, nutrição e bem-estar de seus cavalos, o conhecimento dos proprietários sobre práticas corretas de manejo e mudanças clínicas pode potencialmente afetar a saúde imediata de seus cavalos, além de ter um impacto na prevenção de propagação das doenças no rebanho. A adoção de práticas de manejo para prevenir a introdução e disseminação de patógenos depende de uma variedade de fatores, incluindo dados demográficos, consciência do problema, responsabilidade percebida, crenças anteriores e normas socioculturais. Este trabalho teve como objetivo avaliar as práticas de manejo da saúde e o nível de conhecimento sobre doenças infecciosas de proprietários de equinos no estado do Rio Grande do Norte, Brasil Brasil. As amostras incluíram proprietários de cavalos, independentemente da duração da posse, experiência ou esporte praticado. O questionário abordou temas relacionados às instalações onde os cavalos eram mantidos, além do manejo higiênico-sanitário dos animais. Participaram do estudo 302 proprietários de cavalos distribuídos em 60 dos 167 municípios do estado do Rio Grande do Norte. Dentre os proprietários entrevistados, 63,90% (193/302) responderam que não colocam em quarentena os animais introduzidos no rebanho ou que estão visitando a propriedade. Em relação ao programa de desverminação, 95,03% (287/302) proprietários administravam vermifugação regularmente aos seus animais. No entanto, pouco mais da metade procura orientação veterinária (54,30%). Investir em programas de educação e conscientização dos proprietários de equinos do estado do Rio Grande do Norte sobre as principais doenças infecciosas em equinos é fundamental para melhorar o manejo sanitário e a saúde geral dos animais. Proprietários informados desempenham um papel essencial na criação de ambientes mais seguros para os cavalos, contribuindo para a sustentabilidade da indústria equina como um todo.

Consultorio de Atención Inmediata como estrategia de gestión de calidad en el Servicio de Emergencia de un hospital de Lima, Perú

Objetivo: Determinar la eficacia de la implementación del Consultorio de Atención Inmediata como estrategia de gestión de calidad en el Servicio de Emergencia de un hospital público de Lima, Perú. Materiales y métodos: Estudio analítico, cuasi experimental de antes y después, con grupos diferentes, que se realizó en 338 usuarios externos atendidos en el Servicio de Emergencia del Hospital María Auxiliadora. Se evaluó el tiempo de espera antes y después de la implementación del Consultorio de Atención Inmediata, así como la satisfacción a través del cuestionario SERVQUAL modificado -validado y recomendado por el Ministerio de Salud (Minsa) y aplicado en el grupo de posimplementación-, además de su relación con el tiempo de espera obtenido. El análisis se realizó a través del software de IBM SPSS S25.0 mediante medidas de frecuencias y porcentajes, diferencia de medias en grupos distintos con el test de Levene y la medida no paramétrica del coeficiente de correlación de Spearman con un nivel de significancia p < 0,05. Resultados: Los resultados mostraron predominio del sexo femenino (60,95 %), en el rango de edad de 14 a 29 años (24,56 %), en la prioridad IV (67,16 %); el tiempo de espera para la atención tuvo una media de 17,70 previo a la implementación y una media de 4,27 posterior a esta, por lo tanto, hubo una diferencia significativa después de la estrategia de gestión (p < 0,00). La satisfacción del Consultorio de Atención Inmediata se obtuvo en el 56,21 % de los usuarios externos, con énfasis en la dimensión empatía (76,33 %) y capacidad de respuesta (69,23 %), mientras que la dimensión con menor satisfacción fue la fiabilidad (48,52 %), además de obtener una correlación significativa inversa entre el tiempo de espera y la satisfacción (p < 0,01 y rho: -0,39). Conclusiones: La implementación del Consultorio de Atención Inmediata en el Servicio de Emergencia fue eficaz; en consecuencia, el tiempo de espera disminuyó, lo cual, a su vez, generó satisfacción en el usuario externo.

Objective: To determine the effectiveness of the implementation of the Immediate Care Office as a quality management strategy at the Emergency Service of a public hospital in Lima, Peru. Materials and methods: An analytical, quasi-experimental, before-and-after study conducted with 338 outpatients from different groups treated at the Emergency Service of Hospital María Auxiliadora. Before and after the implementation of the Immediate Care Office, waiting time, satisfaction-assessed through the modified SERVQUAL questionnaire, which was validated and recommended by the Ministry of Health and administered to the postimplementation group-as well as the relationship between satisfaction and waiting time were evaluated. The analysis was performed using IBM SPSS statistics V25.0, frequencies and percentages, the mean difference of both groups obtained through the Levene's test, and the nonparametric measurement of the Spearman's correlation coefficient with a significance level of p < 0.05. Results: The results showed a predominance of the female sex (60.95 %), the 14-to-29-year age range (24.56 %) and the Emergency Severity Index level IV (67.16 %). The average waiting time accounted for 17.70 and 4.27 before and after the office implementation, respectively. Therefore, there was a significant difference after the management strategy (p < 0.00). Out of all outpatients, 56.21 % were satisfied with the implementation of the Immediate Care Office, mainly with the empathy (76.33 %) and responsiveness (69.23 %) dimensions, while reliability was the dimension with the lowest satisfaction score (48.52 %). Additionally, there was a significant inverse correlation between waiting time and satisfaction (p < 0.01 and rho: -0.39). Conclusions: The implementation of the Immediate Care Office at the Emergency Service was effective since it reduced the waiting time, which in turn brought satisfaction to the outpatients.

La gestión sanitaria en la atención a la población indígena y afroperuana en la pandemia por la COVID-19

Objetivo : Conocer las barreras en la gestión de los establecimientos de salud que atienden a población indígena y afrodescendiente del Perú. Material y métodos : Se diseñó una encuesta virtual en gestión sanitaria al personal del primer nivel de atención de 89 establecimientos de salud (EESS) de 27 provincias, durante los meses de octubre y noviembre del 2021. Resultados : En el 73 % de EESS, el personal refiere no conocer el plan contra la tercera ola pandémica, 14,8% de EESS el personal refiere no está capacitado en manejo de la COVID-19, en el 22,7% de EESS se reunieron para coordinar cómo enfrentar la tercera ola pandémica, en el 83% de EESS el personal refiere no contar con presupuesto para su plan contra la COVID-19. Conclusiones : Hay barreras en la visión, gestión y presupuesto en EESS que atienden poblaciones indígenas y afroperuano, lo que afectaría la ejecución eficaz de estrategias para el control de la pandemia por la COVID-19.

Objective : To determine the barriers in the management of health facilities that serve the indigenous and Afro-descendant population in Peru. Material and methods : A virtual survey on health management was designed for first level health care personnel in 89 health facilities (EESS) in 27 provinces during October and November 2021. Results : In 73% of the EESS, the personnel reported not knowing the plan against the third pandemic wave, 14.8% of the EESS reported not being trained in the management of COVID-19, in 22.7% of the EESS they met to coordinate how to face the third pandemic wave, in 83% of the EESS the personnel reported not having a budget for their plan against COVID-19. Conclusions : There are barriers in the vision, management and budget in EESS that serve indigenous and Afro-Peruvian populations, which would affect the effective execution of strategies for the control of the pandemic by COVID-19.

[Management and impact of interventions to reduce COVID-19 cases in Costa RicaGestão e impacto das medidas de intervenção para reduzir os casos de COVID-19 na Costa Rica]. / Gestión e impacto de las medidas de intervención para la reducción de casos por COVID-19 en Costa Rica.

Objective: Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods: A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results: The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion: The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.

Objetivo: Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método: Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados: Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão: A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

Gestión e impacto de las medidas de intervención para la reducción de casos por COVID-19 en Costa Rica / Management and impact of interventions to reduce COVID-19 cases in Costa Rica / Gestão e impacto das medidas de intervenção para reduzir os casos de COVID-19 na Costa Rica

RESUMEN Objetivo. Evaluar el impacto de las intervenciones introducidas en Costa Rica durante 2020 y 2021 para el control de la pandemia por COVID-19. Método. Se empleó un modelo bayesiano de regresión de Poisson que incorporó las medidas de control o intervención como variables independientes sobre la modificación de la cantidad de casos por semana epidemiológica. Resultados. Los resultados evidenciaron el efecto relativo y conjunto que han tenido las políticas o medidas de contención en la reducción de casos, principalmente la restricción vehicular, el uso de mascarillas y la puesta en práctica de los lineamientos y protocolos sanitarios. Las evidencias de los efectos se optimizaron y se pusieron a disposición para la toma de decisiones de las autoridades sanitarias y de emergencia del país. Se generaron varias iteraciones para el monitoreo constante de la variación en los efectos en cuatro momentos distintos del avance de la pandemia. Conclusión. La aplicación simultánea de distintas medidas de mitigación en Costa Rica ha sido un agente promotor de la disminución de casos de COVID-19.

ABSTRACT Objective. Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods. A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results. The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion. The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.

RESUMO Objetivo. Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método. Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados. Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão. A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

Dietitians View of Foodservice Sanitary Practices and Demands in Long-Term Care Hospitals.

This study aimed to investigate the current state of foodservice management and demands for improvement in long-term care hospitals. The survey was performed in experienced dietitians working at 25 hospitals. General characteristics, status of sanitary management (document management, self-assessment of importance and performance), necessity and ranking of sanitary management items were investigated. Approximately 2.5 dietitians worked in each hospital, but only 7 (28.0%) hospitals employed clinical dietitians. From the questionnaire, the scores of the importance in sanitary management and performance were 4.5 ± 0.7 and 4.3 ± 0.9, respectively, and were significantly different (p = 0.000). Participants also reported "special therapeutic diets management" and "compliance with standards of refrigerating time, food, method management" had the lowest importance and performance, respectively. The result of Importance-Performance Analysis revealed a significant positive correlation between importance and performance (R2 = 0.427). However, items such as "performing hand hygiene" and "compliance with standards of refrigerating time, food, method" and etc. had low importance recognition with low performance. All participants reported "preparing sanitary management standards was necessary" is necessary and "development of sanitary management manual" is the most important. These findings suggest that sanitary management is important in food service management of long-term care hospitals, and improving awareness is required. Developing a hospital foodservice hygiene manual would ensure better safety and quality for patient care and public health.

Fatores associados à infecção pelo vírus da estomatite vesicular em equídeos no estado do Rio Grande do Norte, Brasil / Factors associated with infection by the vesicular stomatitis virus in equines in the state of Rio Grande do Norte, Brazil

Objetivou-se investigar a presença do Vírus da Estomatite Vesicular (VEV) e seus fatores de risco para ocorrência e disseminação da enfermidade em equídeos das mesorregiões Leste e Oeste Potiguar do estado do Rio Grande do Norte, Brasil. Foram analisadas pela técnica de virusneutralização, 809 amostras sanguíneas de equídeos provenientes de noventa propriedades de dezesseis municípios Potiguares durante os meses de julho de 2018 a fevereiro de 2019. Os fatores de riscos associados ao VEV foram avaliados por meio de questionário epidemiológico e os dados submetidos a análise estatística no programa IBM SPSS Statistics versão 21.0 com nível de confiança de 95%. Posteriormente, todas as variáveis estatisticamente significantes foram submetidas a análise de regressão de Poisson. A soroprevalência de anticorpos anti-VEV foi 24,6% (199/809), sendo 3,2% (13/402) de soropositivos na mesorregião Leste e 45,7% (186/407) na do Oeste Potiguar. Com relação aos sorotipos, observou-se uma prevalência de 3,8% (31/809) e 24,5% (198/809) para Indiana 2 e 3 respectivamente, com 15,1% (30/198) de coinfecção. Equídeos criados na mesorregião Oeste, em propriedades que não realizam quarentena e onde os animais enfermos são mantidos no rebanho, foram consideradas fatores predisponentes a infecção pelo VEV. Esses resultados demonstram a circulação do VEV em equídeos no Rio Grande do Norte, com destaque ao Oeste Potiguar, e sendo necessário a aplicação de medidas sanitárias que impeçam introdução e disseminação do vírus ente as espécies susceptíveis, principalmente em condições climáticas favoráveis para a sua manutenção, no ambiente de criação e pastagens.

This study aimed to investigate the presence of Vesicular stomatitis virus (VSV) and risk factors for its occurrence and dissemination in equines from the Eastern and Western mesoregions of the state of Rio Grande do Norte, Brazil. Blood samples were analyzed, by Serum Virus Neutralization Assay, from 809 animals belonging to 90 properties distributed in sixteen municipalities from July 2018 to February 2019. Risk factors were assessed using an epidemiological questionnaire. Data were submitted to statistical analysis using the software IBM SPSS Statistics, version 21.0 with a 95% confidence level. Also, all statistically significant variables were subjected to Poisson regression analysis. The occurrence of anti-VSV antibodies was 24.6% (199/809) with 3.2% (13/402) and 45.7% (186/407) of seropositivity in the Western and Eastern mesoregion, respectively. Regarding serotypes, there were an occurrence of 3.8% (31/809) and 24.5% (198/809) for Indiana 2 and 3, respectively, and 15.1% (30/198) of co-infection for both. Equines kept of the Western mesoregion, on properties that do not quarantine, and where sick animals are kept in the herd, were considered risk factors for LVV infection. These results demonstrate the presence of VSV in equines in Rio Grande do Norte, with emphasis on Oeste Potiguar, and that sanitary measures must be adopted to prevent the introduction and viral spreading among susceptible species, especially due to favorable climatic conditions for the maintenance of VSV in the breeding and pasture environment.

Fatores associados à infecção pelo vírus da estomatite vesicular em equídeos no estado do Rio Grande do Norte, Brasil / Factors associated with infection by the vesicular stomatitis virus in equines in the state of Rio Grande do Norte, Brazil

Objetivou-se investigar a presença do Vírus da Estomatite Vesicular (VEV) e seus fatores de risco para ocorrência e disseminação da enfermidade em equídeos das mesorregiões Leste e Oeste Potiguar do estado do Rio Grande do Norte, Brasil. Foram analisadas pela técnica de virusneutralização, 809 amostras sanguíneas de equídeos provenientes de noventa propriedades de dezesseis municípios Potiguares durante os meses de julho de 2018 a fevereiro de 2019. Os fatores de riscos associados ao VEV foram avaliados por meio de questionário epidemiológico e os dados submetidos a análise estatística no programa IBM SPSS Statistics versão 21.0 com nível de confiança de 95%. Posteriormente, todas as variáveis estatisticamente significantes foram submetidas a análise de regressão de Poisson. A soroprevalência de anticorpos anti-VEV foi 24,6% (199/809), sendo 3,2% (13/402) de soropositivos na mesorregião Leste e 45,7% (186/407) na do Oeste Potiguar. Com relação aos sorotipos, observou-se uma prevalência de 3,8% (31/809) e 24,5% (198/809) para Indiana 2 e 3 respectivamente, com 15,1% (30/198) de coinfecção. Equídeos criados na mesorregião Oeste, em propriedades que não realizam quarentena e onde os animais enfermos são mantidos no rebanho, foram consideradas fatores predisponentes a infecção pelo VEV. Esses resultados demonstram a circulação do VEV em equídeos no Rio Grande do Norte, com destaque ao Oeste Potiguar, e sendo necessário a aplicação de medidas sanitárias que impeçam introdução e disseminação do vírus ente as espécies susceptíveis, principalmente em condições climáticas favoráveis para a sua manutenção, no ambiente de criação e pastagens.

This study aimed to investigate the presence of Vesicular stomatitis virus (VSV) and risk factors for its occurrence and dissemination in equines from the Eastern and Western mesoregions of the state of Rio Grande do Norte, Brazil. Blood samples were analyzed, by Serum Virus Neutralization Assay, from 809 animals belonging to 90 properties distributed in sixteen municipalities from July 2018 to February 2019. Risk factors were assessed using an epidemiological questionnaire. Data were submitted to statistical analysis using the software IBM SPSS Statistics, version 21.0 with a 95% confidence level. Also, all statistically significant variables were subjected to Poisson regression analysis. The occurrence of anti-VSV antibodies was 24.6% (199/809) with 3.2% (13/402) and 45.7% (186/407) of seropositivity in the Western and Eastern mesoregion, respectively. Regarding serotypes, there were an occurrence of 3.8% (31/809) and 24.5% (198/809) for Indiana 2 and 3, respectively, and 15.1% (30/198) of co-infection for both. Equines kept of the Western mesoregion, on properties that do not quarantine, and where sick animals are kept in the herd, were considered risk factors for LVV infection. These results demonstrate the presence of VSV in equines in Rio Grande do Norte, with emphasis on Oeste Potiguar, and that sanitary measures must be adopted to prevent the introduction and viral spreading among susceptible species, especially due to favorable climatic conditions for the maintenance of VSV in the breeding and pasture environment.

Good management practices of venomous snakes in captivity to produce biological venom-based medicines: achieving replicability and contributing to pharmaceutical industry.

One of the factors responsible for lack of reproducible findings may be attributed to the raw material used. To date, there are no apparent studies examining reproducibility using venoms for the development of new toxin-based drugs with respect to regulatory agencies' policies. For this reason, protocols were implemented to produce animal toxins with quality, traceability, and strict compliance with Good Manufacturing Practices. This required validation of the production chain from the arrival of the animal to the vivarium, followed by handling, housing, as well as compliance with respect to extraction, freeze-drying, and, finally, storage protocols, aimed at generating compounds to serve as candidate molecules applicable in clinical trials. Currently, to produce quality snake venoms to support reproductive studies, the Center for the Study of Venoms and Venomous Animals (CEVAP) from São Paulo State University (UNESP), São Paulo, Brazil has 449 microchipped snakes through rigid and standardized operating procedures for safety, health, and welfare of animals. Snakes were frequently subjected to vet clinical examination, anthelmintic, and antiparasitic treatment. Venom milk used to destroy prey was collected from each animal in individual plastic microtubes to avoid contamination and for traceability. In addition, venoms were submitted to microbiological, and biochemical toxicological analyses. It is noteworthy that investigators are responsible for caring, maintaining, and manipulating snakes and ensuring their health in captivity. This review aimed to contribute to the pharmaceutical industry the experimental experience and entire snake venom production chain required to generate quality products for therapeutic human consumption.

Evaluation of Sanitary Education and Performance of Sanitary Management among School Food Service Employees in Sejong

This study examined sanitary education and performance of sanitary management among employees related to cooking in school food services in Sejong. A total of 193 subjects (19.2% for kindergarten, 42.5% for elementary school, and 38.3% for middle and high school) participated in this questionnaire survey. The frequency of sanitary education was highest at 63.7% once a month, and it was higher in the order of middle and high school, elementary school, and kindergarten (P < 0.001). The most important contents of sanitary education were personal sanitary management (43.5%), food material management (25.9%), and sanitary and safety management of equipment and utensils (17.6%). The necessity of sanitary education recognized by the subjects was absolutely necessary at 69.9% and necessary at 28.0%. The application of knowledge from sanitary education is high in proper application at 50.8% and absolute application at 40.4%. The improvement effect after sanitary education was higher in kindergarten than in elementary school and middle and high school (P < 0.01). The performance of sanitary management was high at 4.7 out of 5. In particular, personal sanitary management was the highest in elementary school at 4.8 followed in order by middle and high school (4.7) and kindergarten (4.6) (P < 0.01). The necessity of sanitary education and the application of knowledge obtained from sanitary education to the food service showed a significant and positive correlation with the sanitary management performance (P < 0.05, P < 0.001). These results highlight that the need for customized sanitary education for institution types and an awareness of sanitary education by employees will enhance sanitary management in school food service.

Aborto terapéutico, ausencia injustificada en la política sanitaria / Therapeutic abortion, unjustified absence in health policy

A pesar de que el aborto, por razones de salud, no es considerado un delito en el Perú, el Estado niega su inclusión en la política pública, con lo cual infringe el derecho de las mujeres a interrumpir un embarazo cuando este afecta su salud. Al examinar el artículo del Código Penal que exceptúa de delito a este tipo de aborto, se identifican atribuciones que protegen a las mujeres y establecen condiciones para ofertar dicha atención. En el presente documento se pone en debate los argumentos que el Estado Peruano viene usando para no aprobar el Protocolo de Aborto Terapéutico, con el cual se reglamentaria su oferta y financiamiento en los servicios públicos y se fundamenta por qué se debería cumplir con esta obligación, en base al marco conceptual de la “causal salud”. Se presentan, además, dos casos judicializados, en que el Estado Peruano ha sido encontrado responsable de violar los derechos humanos de dos adolescentes a quienes se les negó el aborto terapéutico.

Although abortion for health reasons is not considered a crime in Peru, the State does not allow its inclusion in public policy, thus violating women’s right to terminate a pregnancy when it affects their health. When examining the article in the Criminal Code which decriminalizes this type of abortion, provisions are identified which protect women and set the conditions to offer this type of service. This document sets the debate about the arguments used by the Peruvian State for not approving a therapeutic abortion protocol which would regulate the provision and financing of therapeutic abortion in public services, and explains why this obligation should be complied with, based on the conceptual framework of “health exception”. In addition, it presents two cases brought before the judicial court in which the Peruvian State was found guilty of violating the human rights of two adolescents to whom a therapeutic abortion was denied.

Food Sanitation Management at Foodservice of Correctional Institutions in Korea

The purpose of this study was to investigate the equipment ratio of sanitary facility/equipment as well as the sanitary management performance level at foodservice of correctional institutions in Korea. For this purpose, a total of 47 questionnaires were distributed to dietitians working at correctional institutions during the period from March 20th to May 18th of 2008. A total of 38 questionnaires (response rate 81%) was analyzed using SPSS (windows ver. 14.0). The majority of the respondents were females (65.8%), 35 years or older (55.3%), with 7 years or longer experiences (65.8%), and with education level of university or higher (60.5%). Among the institutions, 39.5% had less than 500, 28.9% had 501 or more but less than 1,200, and 31.6% had 1,201 or more inmates. The equipment ratio of the sanitary facilities/equipment was 49.7%, which was relatively low. Most dietitians perceived 'limited availability of facilities and equipment' and 'the lack of support from financing department' as the major barriers in implementing a desirable sanitary system. On the other hand, perceived sanitary management performance was rated by the respondents as being between 2.55 to 4.50 (5-point Likert scale)-'Cleaning hands properly as specified' showed the lowest performance, whereas 'Sampling preserved meals by standard methodology' showed the highest. The results of this study suggest that a sanitary education program designed for inmate food handlers is needed for successful sanitary management.

Factors Related to Sanitary Management Performance Based on HACCP System in School Foodservice: Seoul, Gyeonggi, Kangwon and Choongchung Areas in Korea / 대한지역사회영양학회지

The purpose of this study was to analysis the sanitary management performance based on HACCP system for school foodservice. This study was carried out from September 2008 until December 2008 and is targeted towards schools' dietitians that work at schools with school foodservice. The regional distribution of this research is as follows; 377 schools in Seoul, 648 schools in Gyeonggido, 160 schools in Kangwondo, 438 schools in Choongchungdo equaling 1,623 schools in total. When school foodservices were put through sanitation management achievement level analysis applied by the HACCP system, results displayed that management of temperature (3.96 points), time (4.08 points), and cross-contamination (4.07 points) were all below the average achievement level. HACCP system's achievement level based on the TQM showed that areas for strategy development, leadership, information and analysis had low achievement levels. Achievement levels for CCP are quality check, delivery/distribution process, sterilization/cleansing of food's contact surface. As a result of multiple regression analysis of the factors that influenced sanitation management achievement level of school foodservice HACCP system; sanitary job standard showed 35.6% and CCP achievement levels showed 26.8% explanatory rate. In particular, Kangwondo's number of foodservice provided to per cook was small. Also, the better the processing management was assessed, the higher the sanitary job standard achievement level became resulting to a explanatory rate of 39.5%. Elementary schools showed a higher explanatory rate of 37.0% than middle and high schools. CCP achievement levels in middle and high schools with self-operated foodservice had a 28.0% variable explanatory rate, which was the highest. The better the drainage system, leadership and assessments turned out to be, the higher the CCP achievement levels became. In summary, to revitalize HACCP system that is based on the TQM, it is considered that proper database of HACCP system for school foodservice's sanitation management be constructed and more emphasis should be put on strategy development to improve customers' satisfactory level. In addition, improvements in achievement levels of time, temperature, and cross-contamination for sanitary job standard and CCP achievement level are essential.

Foodservice Management and Food Sanitation Management in the Welfare Institutions for the Disabled in Korea / 대한지역사회영양학회지

The purpose of this study was to investigate the characteristics of the foodservice management practices, the equipment ratio of sanitary facility/equipment, and dietitians' perceptions of (i) the barriers to sanitary management and (ii) the sanitary management performance level in the welfare institutions for the disabled in Korea. The survey was conducted during the period from September 7 to October 15, 2006. A total of 91 institutions (response rate 74.6%) were analyzed by using SPSS (windows ver. 14.0). The average number of meals served per day per an institution was 379. The majority (93.4%) of dietitians made decisions in procurement. The major part of the purchase was made through private contract. The factors affecting menu planning were nutrition, food preference, and cost, in the order of importance. Among the food items, fruits were infrequently served, while protein source foods and green leaf vegetables were almost daily served. The equipment ratio of sanitary facilities/equipment was 45%, which was relatively low. Most dietitians perceived 'limited availability of facilities and equipment'and 'the lack of support from financing department'as the major barriers in implementing a desirable sanitary system. Sanitary management performance in 'the food ingredient'was perceived as the lowest, while that in 'the uniform'showed the highest. The results of this study suggest that a proper supporting program on securing the facility/equipment and adequately trained employees are needed for successful sanitary management. Also, a more frequent supply of fruits for the disabled is recommended.

Analysis for Internal Audit and External Audit of the Sanitation/Safety Management Performance for the School Foodservice in Gyeongbuk Area / 대한지역사회영양학회지

The purpose of the study was to investigate the effects of the characteristics of dietitians, the characteristics of school food services, equipment ratio of HACCP facility/equipment and perception of barriers to HACCP implementation on external and internal audit of food safety/sanitation management performance in school food service. An e-mail survey was conducted with 144 dietitians in Gyeongbuk Province. A response rate was 57.6% (N=83) and data was analyzed using SPSS windows (ver. 12.0). Dietitian perceived facilities/equipment-related and stakeholder-related as the big barriers in implementing a HACCP system. Total scores of sanitation/safety management performance for external and internal audit were similar at 92 and 91 out of 100, respectively. "Facilities/equipment" and "HACCP system" categories in both external and internal audit were rated the lowest. As dietitian perceived facilities/equipment-related (p<0.001) and stakeholder-related (p<0.05) barriers to HACCP implementation were greater, the scores of the external and internal audits were significantly lower. As dietitian perceived barriers for all categories were greater, the scores of internal audits were significantly lower (p<0.05). As a result of multiple regression analyses, the scores of the external audit was positively associated with career as a school food service dietitian, but was negatively associated with barriers related to facility/equipment, while the scores of the internal audit was negatively associated with barriers related to facility/equipment and employees. This study suggests that supporting programs on securing the facilities/equipment and employee training are needed for successful HACCP implementation in school food service.

Evaluation of the Perceived Performance on Sanitary Management of Cooked Foods in Foodbanks / 대한지역사회영양학회지

A survey was implemented to suggest basic data for assuring the safety of cooked foods in foodbank operations. A questionnaire consisted of total 48 items including general characteristics, basic inputs and perceived importance/performance of sanitary management. One hundred twenty-eight responses among the 267 nationwide foodbanks were used for the statistical analysis. About forty-one percent of foodbanks was operated a period of 1-3 years and 43.0% of them were managed by social welfare organizations. The number of staff was only 0.5 person per operation with the whole responsibility and 1.0 with additional work, and thus most of the work was managed by volunteers. Job satisfaction was shown to be moderate and was affected by specialty and salary mostly. The facilities and equipment in foodbanks were not enough to operate and freezers/refrigerators were the top priority to supplement. Most of the respondents attended a nationwide level sanitary education program (79.7%), but complained not enough frequency of education (90%). The sanitary status of the donated foods was considered as satisfactory but some safety practices had to be improved, including personnel expenses and operating costs in the district level, a sanitary awareness of the donors and a general management of the facilities and equipment. An assessment on sanitary management resulted in an overall average of 4.45 out of 5 points in importance and 3.85 in performance showing the high level of sanitation perception in foodbank managers. From the IPA analysis, the fields found to be improved were sanitation management during cooking and temperature control as well as cleanliness and sanitation of both transport vehicle and refrigerator/freezer. To secure the food safety in foodbanks, consequently, personnel support, supplement of facilities and equipment, intense sanitation education and development of sanitation management program is needed.

A Study on the Sanitary Management of School Foodservice Operations in Daejeon and Chungnam / 대한지역사회영양학회지

This study was conducted to the evaluate sanitary management status of school foodservice in Deajeon and Chungnam and to suggest basic data for sanitary improvement. A questionnaire was used in this study as a survey method. The subjects consist of 529 dietitians that are employed in the school (primary.middle.high school) foodservice. These results may be summarized as follows : 71.0% of surveyed school foodservices managed separately place for contamination and uncontamination. 91.5% didn't maintain adequate temperature at kitchen. A holding rate of hygiene utensils is lower in Chungnam than Daejeon. The dietitian group aged 30 - 34 showed significantly higher scores than other groups in personal hygiene of employees. The dietitian group graduated from a college showed significantly lower scores than other groups in purchasing & receiving, preparation, storage, food remains & waste, kitchen utensils and equipments and personal hygiene. It was significant to serving, personal hygiene and facilities & structure by Daejeon and Chungnam. In serving, Daejeon showed significantly lower scores than Chungnam. In personal hygiene, facilities and structure, Chungnam showed significantly lower scores than Daejeon. The foodservice group (started or = 1990) in preparation.

Evaluation of Sanitary Management based on HACCP of Business and Industry Foodservice Operations in Taegu and Kyungpook Areas

The purpose of this study was to evaluate the status of sanitary management based on HACCP. The surveys which were on various aspects of general characteristics, food handling practice, personal sanitation, equipment sanitation, and equipment possession were carried out using questionnaires for 146 business and industry foodservice operations in Taegu and Kyungpook areas. The results of this study were summarized as follows. Forty-nine percent of surveyed foodservice operations was in Taegu, 51% in Kyungpook and 69.2% in direct foodservice operations and 28.1% in contracted foodservice operations. Seventy-eight percent of foodservice operations replied that they have done only basic sanitary management, while 13% surveyed stated that they were implementing HACCP. Food handling practice and personal sanitation were significantly better in Kyungpook area than in Taegu. Significantly high levels in food handling practice, personal sanitation, equipment sanitation, and equipment possession were seen in foodservice operations which had more than 1,000 meal served than those which had less than 1,000 meals served. According to the results of food handling practice, in items of food-temperature measurement during receiving, cooking, holding after cooking, and reheating, foodservice operations showed very low scores below the average. All foodservice operations presented good scores in the parts of personal and equipment sanitation. In equipment possession, sterilizing systems were generally not enough, dishwasher and sterilizing facilities of contracted foodservice operation showed significantly high scores. Therefore, the business and industry foodservice operations will have to pay special attention to temperature management in the foodservice production process as the first step to implement of HACCP.

Current Information and Sanitaion Status of Professional Catering Companies / 대한지역사회영양학회지

A survey was performed to provide current information on professional catering companies. Twenty-three catering companies out of thirty-eight(60% recovery) responded the survey for December in 1998. Foodservice establishments managed by 16 small-middle sized catering companies provided an average of 11,200 meals daily, while those managed by major and small-middle sized catering companies were mainly office(72.2%, 57.1%) and school foodservice(15.2%, 26%). The rates of sales of major catering companies and small-middle sized catering companies increased 24%, 30% respectively in 1998. Self-evaluation in catering companies was conducted for sanitary management. Unsatisfactory results from self evaluation were found in three categories, such as, measurement of internal temperature of food materials at reception, ventilation system in the working area, and hand-washing stations with equipment cleaning and sanitizing facilities in front of the working area. Most catering companies expressed a willingness to apply the Hazard Analysis Critical Control Point (HACCP) system from this survey. "Professional catering business has arisen as an area requiring more consideration and further study for the production of a safe food."