Heavy metals in soils and edible tissues of Lepidium meyenii (maca) and health risk assessment in areas influenced by mining activity in the Central region of Peru.

Heavy metal contamination of soil and agricultural products is an environmental problem, has an adverse effect on the quality of food crops, and is a danger to food security and public health. The concentration of arsenic (As), cadmium (Cd), lead (Pb), iron (Fe) and zinc (Zn) in surface soils and edible hypocotyls tissues of two ecotypes of Lepidium meyenii Walpers (maca) was evaluated in three districts of the Junín province, Peru. In addition, the risk to human health due to exposure to heavy metals from maca consumption was evaluated. Soil samples and maca hypocotyls were collected in areas influenced by mining and metallurgical activity. The mean concentration of Cd (0.32 ± 0.23 mg/kg) and Pb (0.20 ± 0.12 mg/kg) in maca samples exceeded the values established by the Food and Agriculture Organization and the World Health Organization. The bioconcentration factor was less than 1. The estimated daily intake of each metal was below the oral reference dose. The hazard quotient and hazard index were less than 1, it is unlikely to cause non-cancer adverse health outcome. The cancer risk for As and Cd was higher than the tolerable limit (1 × 10-6) in children and adults. In the district of Ondores, the cancer risk for As in children was higher than the acceptable limit (1 × 10-4). Residents of the Ondores district would be more exposed to As and Cd from consumption of maca hypocotyls. It is very important to carry out continuous monitoring of other toxic metals in different ecotypes of maca (red, black, yellow, purple, creamy white, pink) in order to evaluate the variation in the accumulation of heavy metals and the level of toxicity of each metal between ecotypes.

Qualitative Description of Global Health Nursing Competencies by Nursing Faculty in Africa and the Americas.

OBJECTIVE: to analyze qualitative comments from four surveys asking nursing faculty to rate the importance of 30 global health competencies for undergraduate nursing programs. METHOD: qualitative descriptive study that included 591 individuals who responded to the survey in English (49 from Africa and 542 from the Americas), 163 who responded to the survey in Spanish (all from Latin America), and 222 Brazilian faculty who responded to the survey in Portuguese. Qualitative comments were recorded at the end of the surveys by 175 respondents to the English survey, 75 to the Spanish survey, and 70 to the Portuguese survey. Qualitative description and a committee approach guided data analysis. RESULTS: ten new categories of global health competencies emerged from the analysis. Faculty also demonstrated concern about how and when these competencies could be integrated into nursing curricula. CONCLUSION: the additional categories should be considered for addition to the previously identified global health competencies. These, in addition to the guidance about integration into existing curricula, can be used to guide refinement of the original list of global health competencies. Further research is needed to seek consensus about these competencies and to develop recommendations and standards to guide nursing curriculum development.

Qualitative Description of Global Health Nursing Competencies by Nursing Faculty in Africa and the Americas / Descrição Qualitativa das Competências em Saúde Global por Docentes de Enfermagem na África e nas Américas / Descripción Cualitativa de las Competencias de Salud Global por Docentes de Enfermería en África y las Américas

Abstract Objective: to analyze qualitative comments from four surveys asking nursing faculty to rate the importance of 30 global health competencies for undergraduate nursing programs. Method: qualitative descriptive study that included 591 individuals who responded to the survey in English (49 from Africa and 542 from the Americas), 163 who responded to the survey in Spanish (all from Latin America), and 222 Brazilian faculty who responded to the survey in Portuguese. Qualitative comments were recorded at the end of the surveys by 175 respondents to the English survey, 75 to the Spanish survey, and 70 to the Portuguese survey. Qualitative description and a committee approach guided data analysis. Results: ten new categories of global health competencies emerged from the analysis. Faculty also demonstrated concern about how and when these competencies could be integrated into nursing curricula. Conclusion: the additional categories should be considered for addition to the previously identified global health competencies. These, in addition to the guidance about integration into existing curricula, can be used to guide refinement of the original list of global health competencies. Further research is needed to seek consensus about these competencies and to develop recommendations and standards to guide nursing curriculum development.

Resumo Objetivo: analisar os dados qualitativos obtidos em quatro surveys realizados com docentes de enfermagem que avaliaram a importância de 30 competências em saúde global para cursos de graduação em enfermagem. Métodos: pesquisa qualitativa-descritiva com 591 indivíduos que responderam ao survey em inglês (49 da África e 542 das Américas), 163 que responderam ao survey em espanhol (todos da América Latina), e 222 docentes brasileiros que responderam ao survey em português. Os comentários qualitativos foram registrados ao final dos surveys por 175 respondentes na língua inglesa, 75 na espanhola e 70 na portuguesa. A análise dos dados foi dirigida por uma descrição qualitativa e desenvolvido por um comitê. Resultados: a análise revelou dez novas categorias de competências em saúde global. Os docentes também se mostraram preocupados com a forma e o momento de integrar essas competências nos currículos de enfermagem. Conclusão: as categorias adicionais devem ser consideradas para inclusão nas competências em saúde global identificadas anteriormente. Essas, além das orientações para fins de integração nos currículos existentes, podem ser usadas para direcionar o refinamento da lista original de competências em saúde global. São necessárias outras investigações em busca de consenso sobre essas competências para formulação de recomendações e padrões que orientem o desenvolvimento dos currículos de enfermagem.

Resumen Objetivo: analizar los comentarios cualitativos de cuatro encuestas entre docentes de enfermería, a los que se solicitò evaluar la importancia de 30 competencias de salud global para cursos de pregrado en enfermería. Métodos: investigación cualitativa-descriptiva con 591 individuos que contestaron la encuesta en inglés (49 de África y 542 de las Américas), 163 que contestaron la encuesta en español (todos de América Latina), y 222 docentes brasileños que contestaron la encuesta en portugués. Los comentarios cualitativos fueron registrados al final de las encuestas por 175 respondientes en inglés, 75 en español y 70 en portugués. El análisis de los datos consistió en una descripción cualitativa y aproximación a través de un comité. Resultados: el análisis reveló diez nuevas categorías de competencias de salud global. Los docentes también se mostraron preocupados con la forma y el momento de integrar esas competencias en los currículos de enfermería. Conclusión: las categorías adicionales deben ser consideradas para inclusión en las competencias de salud global identificadas anteriormente. Esas, además de las orientaciones para integración en los currículos existentes, pueden ser usadas para dirigir la lista original de competencias en salud global. Son necesarias otras investigaciones en búsqueda de consenso sobre estas competencias y para desarrollar recomendaciones y normas que guíen los currículos de enfermería.

Global health competencies for nurses in the Americas.

This article reports the findings from an online survey of nursing faculty from the United States, Canada, Latin America, and Caribbean countries to identify their perceptions about global health competencies for undergraduate nursing students. A list of global health competencies for medical students developed by the Association of Faculties of Medicine of Canada Resource Group on Global Health and the Global Health Education Consortium was adapted for nurses and translated from English to Spanish and Portuguese. The competencies were divided into six subscales, and respondents rated each competency on a 4-point Likert scale, with high scores reflecting strong agreement that the competency was essential for undergraduate nursing students. E-mail invitations and links to the online survey were distributed using a nonprobability convenience sampling strategy. This article reports findings only from the respondents to the English and Spanish surveys. The final sample included 542 responses to the English survey and 51 responses to the Spanish survey. Cronbach's alpha reliability coefficients for the subscales ranged from .78 to .96. The mean values for all 6 subscales and for each of the 30 items were greater than 3.0 for the respondents to the Spanish survey, and the mean values for 27 of the items were greater than 3.0 for the respondents to the English survey. These findings suggest that respondents perceived the competencies as essential global health competencies for undergraduate nursing students in the Americas. Narrative comments written by respondents indicate additional competencies and specific concerns about adding additional content to an already full curricula. Results of this study can be used to guide faculty deliberations about global health competencies that should be incorporated in the nursing curricula.

Prevalencia de hiperlipemia en Asunción y área metropolitana / Annual Reports 1992 / Prevalence of hyperlipemia in Asunción and metropolitan areas

In this study, 1606 individuals were studied in order to establish the prevalence of hyperlipemia in Asunción and metropolitan areas. The prevalence of hyperlipemia was 12.8 percent, and acoording to age the hypercholesterolemia was: 7.4 percent (20 to 49 years), 8.5 percent (50 to 59 years), and 12.9 percent (more than 60 years) for a moderate fisk of acquiringa cardiovascular diseae. For a high risk, percentages were as follows: 6.7 percent (20 to 49 years), 95 percent (50 to 59 years) and 13.3 percent (more than 60 years). Our results and the frequent association of hyperlipemia to risk factors of cardiovascular disease show the necessity of considering hyperlipemia as a public health problem

Prevalencia de los factores de riesgo de enfermedades cardiovasculares en Asunción, Paraguay. Informe preliminar / Annual Reports 1992 / Prevalence of risk factors for cardiovascular diseaes in Asunción, Paraguay. Preliminary Report

This is the first research effort investigating cardiovascular risk in Paraguay. We report results of our ongoing cross-sectional prevalence study of riskfactors for coronary heart disease in the first 497 of 2,000 adult volunteers recruited from a population-based sample of households selected by a random process from the catchment area of 10 public outpatient health care facilities in grater Asunción. Consenting adults were interviewed, received a physical examination and grave blood specimens after a 12-huor fast at the corresponding facility to measure glycemia, cholesterol, triglycerides, insulinemia and 2-huor glucose tolerance. Specimens were processed at the IICS according to international standards. Although there is a preponderance of female subjects in this first group studied, results are similar to those obtained in population elsewhere, particulary with respect to high blood pressure (about 24 percent), diabetes mellitus (8 percent) and glucose intolerance (11 percent), diagnosed according to WHO criteria.Almost one half of diabetic and about one fifth of hypertensives had not known of their diagnosis. In accordance to body mass index, over 27 percent of women and about 32 percent of men were found obese, but 28 percent of obese women hes extreme obesity in comparison to only 17 percent of men. Hypercholesterolemia compatible with a moderate risk for CVD ranged from 7.5 to 9.8 percent, but the cholesterol level associated with a high risk for CVD was almost double (13 percent) in individuals over 40 years of age. About 13 percent of the population had a triglyceride level superior o igual a 200 mg/dl.About 2 percent of subjects studied were smokers