Advances and knowledge gaps on climate change impacts on honey bees and beekeeping: A systematic review.

The Western honey bee Apis mellifera is a managed species that provides diverse hive products and contributing to wild plant pollination, as well as being a critical component of crop pollination systems worldwide. High mortality rates have been reported in different continents attributed to different factors, including pesticides, pests, diseases, and lack of floral resources. Furthermore, climate change has been identified as a potential driver negatively impacting pollinators, but it is still unclear how it could affect honey bee populations. In this context, we carried out a systematic review to synthesize the effects of climate change on honey bees and beekeeping activities. A total of 90 articles were identified, providing insight into potential impacts (negative, neutral, and positive) on honey bees and beekeeping. Interest in climate change's impact on honey bees has increased in the last decade, with studies mainly focusing on honey bee individuals, using empirical and experimental approaches, and performed at short-spatial (<10 km) and temporal (<5 years) scales. Moreover, environmental analyses were mainly based on short-term data (weather) and concentrated on only a few countries. Environmental variables such as temperature, precipitation, and wind were widely studied and had generalized negative effects on different biological and ecological aspects of honey bees. Food reserves, plant-pollinator networks, mortality, gene expression, and metabolism were negatively impacted. Knowledge gaps included a lack of studies at the apiary and beekeeper level, a limited number of predictive and perception studies, poor representation of large-spatial and mid-term scales, a lack of climate analysis, and a poor understanding of the potential impacts of pests and diseases. Finally, climate change's impacts on global beekeeping are still an emergent issue. This is mainly due to their diverse effects on honey bees and the potential necessity of implementing adaptation measures to sustain this activity under complex environmental scenarios.

La abeja occidental Apis mellifera es una especie manejada que proporciona diversos productos de la colmena y servicios de polinización, los cuales son cruciales para plantas silvestres y cultivos en todo el mundo. En distintos continentes se han registrado altas tasas de mortalidad, las cuales son atribuidas a diversos factores, como el uso de pesticidas, plagas, enfermedades y falta de recursos florales. Además, el cambio climático ha sido identificado como un potencial factor que afecta negativamente a los polinizadores, pero aún no está claro cómo podría afectar a las poblaciones de abejas melíferas. En este contexto, realizamos una revisión sistemática de la literatura disponible para sintetizar los efectos del cambio climático en las abejas melíferas y las actividades apícolas. En total, se identificaron 90 artículos que proporcionaron información sobre los posibles efectos (negativos, neutros y positivos) en las abejas melíferas y la apicultura. El interés por el impacto del cambio climático en las abejas melíferas ha aumentado en la última década, con estudios centrados principalmente en individuos de abejas melíferas, utilizando enfoques empíricos y experimentales y realizados a escalas espaciales (<10 km) y temporales (<5 años) cortas. Además, los análisis ambientales fueron basaron principalmente en datos a corto plazo (meteorológicos) y se concentraron sólo en algunos países. Variables ambientales como la temperatura, las precipitaciones y el viento fueron ampliamente estudiadas y tuvieron efectos negativos generalizados sobre distintos aspectos biológicos y ecológicos de las abejas melíferas. Además, las reservas alimenticias, las interacciones planta-polinizador, la mortalidad, la expresión génica y el metabolismo se vieron afectados negativamente. Entre los vacios de conocimiento cabe mencionar la falta de estudios a nivel de colmenar y apicultor, la escasez de estudios de predicción y percepción, la escasa representación de las grandes escalas espaciales y a mediano plazo, el déficit de análisis climáticos y la escasa comprensión de los impactos potenciales de plagas y enfermedades. Por último, las repercusiones del cambio climático en la apicultura mundial siguen siendo un tema emergente, que debe estudiarse en los distintos países. Esto se debe principalmente a sus diversos efectos sobre las abejas melíferas y a la necesidad potencial de aplicar medidas de adaptación para mantener esta actividad crucial en escenarios medioambientales complejos.

Vitamin A deficiency impairs neutrophil-mediated control of Salmonella via SLC11A1 in mice.

In sub-Saharan Africa, multidrug-resistant non-typhoidal Salmonella serovars are a common cause of fatal bloodstream infection. Malnutrition is a predisposing factor, but the underlying mechanisms are unknown. Here we show that vitamin A deficiency, one of the most prevalent micronutrient deficits afflicting African children, increases susceptibility to disseminated non-typhoidal Salmonella disease in mice and impairs terminal neutrophil maturation. Immature neutrophils had reduced expression of Slc11a1, a gene that encodes a metal ion transporter generally thought to restrict pathogen growth in macrophages. Adoptive transfer of SLC11A1-proficient neutrophils, but not SLC11A1-deficient neutrophils, reduced systemic Salmonella burden in Slc11a1-/- mice or mice with vitamin A deficiency. Loss of terminal granulopoiesis regulator CCAAT/enhancer-binding protein ϵ (C/EBPϵ) also decreased neutrophil-mediated control of Salmonella, but not that mediated by peritoneal macrophages. Susceptibility to infection increased in Cebpe-/- Slc11a1+/+ mice compared with wild-type controls, in an Slc11a1-expression-dependent manner. These data suggest that SLC11A1 deficiency impairs Salmonella control in part by blunting neutrophil-mediated defence.

When another one bites the dust: Environmental impact of global copper demand on local communities in the Atacama mining hotspot as registered by tree rings.

Assessing the impact of mining activity on the availability of environmental pollutants is crucial for informing health policies in anticipation of future production scenarios of critical minerals essential for the transition to a net-zero carbon society. However, temporal and spatial monitoring is often sparse, and measurements may not extend far enough back in time. In this study, we utilize variations of chemical elements contained in tree-rings collected in local villages from an area heavily affected by copper mining in the Atacama Desert since the early 20th century to evaluate the temporal distribution of pollutants and their relationship with local drivers. By combining time-varying data on local drivers, such as copper production and the dry tailings deposit area, we show how the surge in copper production during the 1990s, fueled by trade liberalization and increased international demand, led to a significant increment in the availability of metal(loid)s related to mining activities on indigenous lands. Our findings suggest that the environmental legislation in Chile may be underestimating the environmental impact of tailing dams in neighboring populations, affecting the well-being of Indigenous Peoples from the Atacama mining hotspot region. We argue that future changes in production rates driven by international demand could have negative repercussions on the environment and local communities. Therefore, mining emissions and the management of tailing dams should be carefully considered to anticipate their potential negative effects on human and ecosystem health.

Correction: Bustamante et al. Impact of Potassium Pre-Harvest Applications on Fruit Quality and Condition of Sweet Cherry (Prunus avium L.) Cultivated under Plastic Covers in Southern Chile Orchards. Plants 2021, 10, 2778.

In the original publication [...].

Co-Infection by LF-89-Like and EM-90-Like Genogroups of Piscirickettsia Salmonis in Farmed Atlantic Salmon in Chile: Implications for Surveillance and Control of Piscirickettsiosis.

Piscirickettsiosis (SRS), caused by Piscirickettsia salmonis, is the main infectious disease that affects farmed Atlantic salmon in Chile. Currently, the official surveillance and control plan for SRS in Chile is based only on the detection of P. salmonis, but neither of its genogroups (LF-89-like and EM-90-like) are included. Surveillance at the genogroup level is essential not only for defining and evaluating the vaccination strategy against SRS, but it is also of utmost importance for early diagnosis, clinical prognosis in the field, treatment, and control of the disease. The objectives of this study were to characterize the spatio-temporal distribution of P. salmonis genogroups using genogroup-specific real-time probe-based polymerase chain reaction (qPCR) to discriminate between LF-89-like and EM-90-like within and between seawater farms, individual fish, and tissues/organs during early infection in Atlantic salmon under field conditions. The spatio-temporal distribution of LF-89-like and EM-90-like was shown to be highly variable within and between seawater farms. P. salmonis infection was also proven to be caused by both genogroups at farm, fish, and tissue levels. Our study demonstrated for the first time a complex co-infection by P. salmonis LF-89-like and EM-90-like in Atlantic salmon. Liver nodules (moderate and severe) were strongly associated with EM-90-like infection, but this phenotype was not detected by infection with LF-89-like or co-infection of both genogroups. The detection rate of P. salmonis LF-89-like increased significantly between 2017 and 2021 and was the most prevalent genogroup in Chilean salmon aquaculture during this period. Lastly, a novel strategy to identify P. salmonis genogroups based on novel genogroup-specific qPCR for LF-89-like and EM-90-like genogroups is suggested.

Anticipated and Experienced Stigma After Testing Positive for SARS-CoV-2: A Qualitative Study.

INTRODUCTION: Stigma has inhibited public health practitioners' influence during the COVID-19 pandemic. We explore the experienced and anticipated stigma of people affiliated with a large university in the United States, using the Health Stigma and Discrimination Framework. METHODS: We conducted a qualitative secondary substudy of 20 people who tested SARS-CoV-2 positive and 10 who tested negative in the summer of 2020, selected from a study of 3,324 university students and employees. FINDINGS: No participants reported anticipated stigmatization prior to testing positive. However, eight of 20 participants recounted stigma marking (being marked by COVID-19 diagnosis or membership in a "high-risk" group) or manifestations of stigma after testing positive, including feelings of guilt or shame, and concerns about being judged as selfish or irresponsible. Three described being denied services or social interactions as a result of having had COVID-19, long after their infectiousness ended. Participants noted that clear public health messaging must be paired with detailed scientific information, rather than leaving people to resort to non-experts to understand the science. DISCUSSION: Public health messaging designed to mitigate spread of SARS-CoV-2 and protect the community may perpetuate stigma and exacerbate inequities. As a result, people may avoid testing or treatment, mistrust public health messaging, or even use risk-increasing behavior as coping mechanisms. IMPLICATIONS FOR PRACTICE: Intentional use of language that promotes equity and deters discrimination must be high priority for any COVID-19-related public health messaging. Partnership with community leaders to co-create programs and disseminate messaging is a critical strategy for reducing stigma, especially for historically mistreated groups.

Risky business: A mixed methods study of decision-making regarding COVID-19 risk at a public university in the United States.

Introduction: Until vaccines became available in late 2020, our ability to prevent the spread of COVID-19 within countries depended largely on voluntary adherence to mitigation measures. However, individual decision-making regarding acceptable COVID-19 risk is complex. To better understand decision-making regarding COVID-19 risk, we conducted a qualitative substudy within a larger Berkeley COVID-19 Safe Campus Initiative (BCSCI) during the summer of 2020, and completed a mixed-methods analysis of factors influencing decision-making. Materials and methods: We interviewed 20 participants who tested positive for SARS-CoV-2 and 10 who remained negative, and analyzed quantitative survey data from 3,324 BCSCI participants. The BCSCI study enrolled university-affiliated people living in the local area during summer of 2020, collected data on behaviors and attitudes toward COVID-19, and conducted SARS-CoV-2 testing at baseline and endline. Results: At baseline, 1362 students (57.5%) and 285 non-students (35.1%) said it had been somewhat or very difficult to comply with COVID-19-related mandates. Most-cited reasons were the need to go out for food/essentials, difficulty of being away from family/friends, and loneliness. Eight interviewees explicitly noted they made decisions partially because of others who may be at high risk. We did not find significant differences between the behaviors of students and non-students. Discussion: Despite prevailing attitudes about irresponsibility of college students during the COVID-19 pandemic, students in our study demonstrated a commitment to making rational choices about risk behavior, not unlike non-students around them. Decision-making was driven by perceived susceptibility to severe disease, need for social interaction, and concern about risk to others. A harm reduction public health approach may be beneficial.

Plastic Covers and Potassium Pre-Harvest Sprays and Their Influence on Antioxidant Properties, Phenolic Profile, and Organic Acids Composition of Sweet Cherry Fruits Cultivated in Southern Chile.

In rainy areas, sweet cherries are cultivated under plastic covers, preventing the cracking of the fruit but decreasing the firmness and acidity of the cherries. We evaluated the impact of plastic cover and pre-harvest K foliar application on quality parameters, antioxidant properties, and phenolic and organic acid compositions in fruits of sweet cherry cv. Regina of Southern Chile. Our results showed that K+ increased firmness, total soluble content, size, fruit weight, and titratable acidity at harvest, independent of the cover factor. The positive impacts of foliar K fertilization on anthocyanins, flavonoids, and phenolic acids could explain the higher antioxidant capacity of fruits. Our study revealed that the additional K doses applied increased malic acid, the main organic acid in cherry fruits, but only in fruits from uncovered trees. In covered trees, the effect was reversed. Citric acid was higher in fruit from covered trees. Our results indicated that tartaric acid also increased with the application of higher K doses; however, this acid was detectable only in uncovered tree fruit. Interestingly, all organic acids were lower in fruits produced in the lower canopy than those detected in fruits harvested from the upper canopy. This showed the positive impact of canopy light exposure on maintaining suitable acidity levels in sweet cherry fruits.

Impact of Potassium Pre-Harvest Applications on Fruit Quality and Condition of Sweet Cherry (Prunus avium L.) Cultivated under Plastic Covers in Southern Chile Orchards.

In rainy locations, sweet cherry is cultivated under plastic covers, which are useful to prevent fruit cracking but decrease cherry quality such as firmness and acidity. Here we evaluate the impact of pre-harvest K foliar applications on harvest and post-harvest fruit quality and condition of sweet cherry cultivated under plastic covers in southern Chile orchards. The study was performed on two commercial orchards (cv. Regina), located in different regions, during two consecutive seasons. In all cases, a conventional K regime (four sprays) was compared to an intensive K regimen (seven sprays). Results showed that cherries from the most southern region revealed lower acidity but higher soluble solids content weight and size. The intensive K regime improved the firmness and acidity of fruits of covered trees at harvest and post-harvest. Moreover, we found that condition defects were higher in fruits from un-covered trees and that trees grown under intensive K regime showed lower levels of cracking at harvest and pitting at post-harvest compared to trees treated with the conventional K regime. Otherwise, pedicel browning was inconsistently affected by K sprays. Our results revealed that an intensive K regime could improve the quality and condition of fruits at harvest and post-harvest in covered orchards of sweet cherry cv. Regina; however, the impacts can significantly vary depending on season and locality.

Leaf Thermal and Chemical Properties as Natural Drivers of Plant Flammability of Native and Exotic Tree Species of the Valparaíso Region, Chile.

Forest fires are one of the main environmental threats in Chile. Fires in this Mediterranean climate region frequently affect native forests and exotic plantations, including in several cases urban and rural settlements. Considering the scarcity of information regarding the fire response dynamics of tree species that are frequently affected by fires, this study aims to establish a flammability classification according to the evolution of the fire initiation risk presented by the most affected forest species in the Valparaíso region. Three exotic species, Eucalyptus globulus, Pinus radiata, and Acacia dealbata, and two native species, Cryptocarya alba and Quillaja saponaria, were studied. Flammability assays indicate that E. globulus, A. dealbata, and C. alba are extremely flammable, whereas P. radiata and Q. saponaria are flammable. Furthermore, E. globulus and A. dealbata have the highest heating values while Q. saponaria has the lowest values. The extreme flammability of E. globulus, A. dealbata, and C. alba indicates a high susceptibility to ignite. Furthermore, the high heat of combustion of E. globulus and A. dealbata can be associated with a high energy release, increasing the risk of fires spreading. In contrast, Q. saponaria has the lowest predisposition to ignite and capacity to release heat. Accordingly, this work shows that all studied tree species contain organic metabolites that are potentially flammable (sesquiterpenes, aliphatic hydrocarbons, alcohol esters, ketones, diterpenes, and triterpenes) and can be considered as drivers of flammability in vegetation. Finally, these preliminary results will aid in the construction of more resilient landscapes in the near future.

Riesgo integrado de asentamientos humanos conurbación Valparaíso - Viña del Mar / Integrated risk of human settlements Valparaíso conurbation: Viña del Mar

El presente documento tiene por objetivo mostrar los resultados del Piloto de Riesgo integrado de Asentamientos humanos, realizado en la Conurbación Valparaíso-Viña del Mar por el Equipo Asentamientos Humanos en el marco del proyecto ARClim. El objetivo del piloto fue construir y validar una metodología para evaluar riesgos en asentamientos humanos frente a múltiples amenazas climáticas. Utilizando de base el marco teórico-metodológico descrito en el working package de asentamientos humanos del proyecto ARCLim (Urquiza et al., 2020) donde se expone una definición integral para abordar el concepto de Riesgo, se construyeron 5 cadenas de impactos relevantes para la población con sus respectivos mapas de amenaza, exposición, sensibilidad y riesgo a escala subcomunal (manzana censal).

Vitamin A supplementation boosts control of antibiotic-resistant Salmonella infection in malnourished mice.

Disseminated disease from non-typhoidal Salmonella enterica strains results in >20% mortality globally. Barriers to effective treatment include emerging multidrug resistance, antibiotic treatment failure, and risk factors such as malnutrition and related micronutrient deficiencies. Individuals in sub-Saharan Africa are disproportionately affected by non-typhoidal S. enterica bloodstream infections. To inform a clinical trial in people, we investigated vitamin A as a treatment in the context of antibiotic treatment failure in a mouse model of vitamin A deficiency. Vitamin A-deficient (VAD) mice exhibited higher systemic bacterial levels with a multidrug-resistant clinical isolate in comparison to mice on a control diet. Sex-specific differences in vitamin A deficiency and disseminated infection with S. enterica serotype Typhimurium (S. Typhimurium) were observed. VAD male mice had decreased weight gain compared to control male mice. Further, infected VAD male mice had significant weight loss and decreased survival during the course of infection. These differences were not apparent in female mice. In a model of disseminated S. Typhimurium infection and antibiotic treatment failure, we assessed the potential of two consecutive doses of vitamin A in alleviating infection in male and female mice on a VAD or control diet. We found that subtherapeutic antibiotic treatment synergized with vitamin A treatment in infected VAD male mice, significantly decreasing systemic bacterial levels, mitigating weight loss and improving survival. These results suggest that assessing vitamin A as a therapy during bacteremia in malnourished patients may lead to improved health outcomes in a subset of patients, especially in the context of antibiotic treatment failure.

Six hundred years of South American tree rings reveal an increase in severe hydroclimatic events since mid-20th century.

South American (SA) societies are highly vulnerable to droughts and pluvials, but lack of long-term climate observations severely limits our understanding of the global processes driving climatic variability in the region. The number and quality of SA climate-sensitive tree ring chronologies have significantly increased in recent decades, now providing a robust network of 286 records for characterizing hydroclimate variability since 1400 CE. We combine this network with a self-calibrated Palmer Drought Severity Index (scPDSI) dataset to derive the South American Drought Atlas (SADA) over the continent south of 12°S. The gridded annual reconstruction of austral summer scPDSI is the most spatially complete estimate of SA hydroclimate to date, and well matches past historical dry/wet events. Relating the SADA to the Australia-New Zealand Drought Atlas, sea surface temperatures and atmospheric pressure fields, we determine that the El Niño-Southern Oscillation (ENSO) and the Southern Annular Mode (SAM) are strongly associated with spatially extended droughts and pluvials over the SADA domain during the past several centuries. SADA also exhibits more extended severe droughts and extreme pluvials since the mid-20th century. Extensive droughts are consistent with the observed 20th-century trend toward positive SAM anomalies concomitant with the weakening of midlatitude Westerlies, while low-level moisture transport intensified by global warming has favored extreme rainfall across the subtropics. The SADA thus provides a long-term context for observed hydroclimatic changes and for 21st-century Intergovernmental Panel on Climate Change (IPCC) projections that suggest SA will experience more frequent/severe droughts and rainfall events as a consequence of increasing greenhouse gas emissions.

Atlantic Salmon Pre-smolt Survivors of Renibacterium salmoninarum Infection Show Inhibited Cell-Mediated Adaptive Immune Response and a Higher Risk of Death During the Late Stage of Infection at Lower Water Temperatures.

Bacterial kidney disease (BKD) is widespread in many areas of the world and can cause substantial economic losses for the salmon aquaculture industry. The objective of this study was to investigate the pathophysiological response and gene expression profiles related to the immune response at different water temperatures and to identify the best immunopathological biomarkers to define a phenotype of resistance to BKD. The abundance of msa transcripts of R. salmoninarum in the head kidney was significantly higher in infected fish at 11°C. R. salmoninarum induced significantly more severe kidney lesions, anemia and impaired renal function at 11°C. In addition, the expression pattern of the genes related to humoral and cell-mediated immune responses in infected fish at 11 and 15°C was very similar, although R. salmoninarum induced a significantly greater downregulation of the adaptive immune response genes at the lower water temperature. These results could be due to a suppressed host response directly related to the lowest water temperature and/or associated with a delayed host response related to the lowest water temperature. Although no significant differences in survival rate were observed, fish infected at the lowest temperature showed a higher probability of death and delayed the mortality curve during the late stage of infection (35 days after infection). Thirty-three immunopathological biomarkers were identified for potential use in the search for a resistance phenotype for BKD, and eight were genes related specifically to the adaptive cell-mediated immune response.

Multidecadal environmental pollution in a mega-industrial area in central Chile registered by tree rings.

One of the most polluted areas in Chile is the Ventanas Industrial Area (VIA; 32.74°S / 71.48°W), which started in 1958 and today comprises around 16 industries in an area of ca. 4 km2. A lack of consistent long-term instrumental records precludes assessing the history of contamination in the area and also limits the evaluation of mitigation actions taken since the late 1980s. Here, we use dendrochemistry as an environmental proxy to analyze environmental changes over several decades at the VIA. We present chemical measurements of tree rings from planted, exotic Cupressus macrocarpa growing near the VIA with 4-year resolution over a period of 52 years (1960-2011). These data provide unprecedented information on regional anthropogenic pollution and are compared with a tree-ring elemental record of 48 years (1964-2011) from the Isla Negra (INE) control site not exposed to VIA emissions. For the 48 years of overlap between both sites, higher concentrations of Zn, V, Co, Cd, Ag, Fe, Cr, and Al were especially registered after the year 2000 at VIA compared to INE for the periods under study. Concentrations of Pb, Cu, As, Fe, Mo, Cr, and Zn increased through time, particularly over the period 1980-1990. Decontamination plans activated in 1992 appear to have had a positive effect on the amount of some elements, but the chemical concentration in the tree rings suggest continued accumulation of pollutants in the environment. Only after several years of implementation of the mitigation measures have some elements tended to decrease in concentration, especially at the end of the evaluated period. Dendrochemistry is a useful tool to provide a long-term perspective of the dynamics of trace metal pollution and represents a powerful approach to monitor air quality variability to extend the instrumental records back in time.

Human-environmental drivers and impacts of the globally extreme 2017 Chilean fires.

In January 2017, hundreds of fires in Mediterranean Chile burnt more than 5000 km2, an area nearly 14 times the 40-year mean. We contextualize these fires in terms of estimates of global fire intensity using MODIS satellite record, and provide an overview of the climatic factors and recent changes in land use that led to the active fire season and estimate the impact of fire emissions to human health. The primary fire activity in late January coincided with extreme fire weather conditions including all-time (1979-2017) daily records for the Fire Weather Index (FWI) and maximum temperature, producing some of the most energetically intense fire events on Earth in the last 15-years. Fire activity was further enabled by a warm moist growing season in 2016 that interrupted an intense drought that started in 2010. The land cover in this region had been extensively modified, with less than 20% of the original native vegetation remaining, and extensive plantations of highly flammable exotic Pinus and Eucalyptus species established since the 1970s. These plantations were disproportionally burnt (44% of the burned area) in 2017, and associated with the highest fire severities, as part of an increasing trend of fire extent in plantations over the past three decades. Smoke from the fires exposed over 9.5 million people to increased concentrations of particulate air pollution, causing an estimated 76 premature deaths and 209 additional admissions to hospital for respiratory and cardiovascular conditions. This study highlights that Mediterranean biogeographic regions with expansive Pinus and Eucalyptus plantations and associated rural depopulation are vulnerable to intense wildfires with wide ranging social, economic, and environmental impacts, which are likely to become more frequent due to longer and more extreme wildfire seasons.

El check list como herramienta para el desarrollo de la seguridad al paciente quirúrgico / The checklist as a tool for the development of the surgical patient safety

Introducción: con el fin de promover la seguridad del paciente quirúrgico la Organización Mundial de la Salud, desarrolla estrategias para reducir los eventos adversos al paciente que va a ser intervenido, diversos países a nivel mundial han extendido la implementación del listado de verificación de la seguridad de la cirugía. Objetivo: profundizar los conocimientos y la convicción de los profesionales en la identificación de controles de seguridad de la cirugía para la prevención de daños al paciente quirúrgico. Desarrollo: los eventos adversos son más frecuentes en los pacientes quirúrgicos que en los de cualquier otra especialidad. Los pacientes al ser intervenidos quirúrgicamente, son más vulnerables a complicaciones producidas por errores profesionales. El cumplimiento de protocolos como el Check list garantiza la seguridad del paciente y acredita la buena praxis por parte de los profesionales sanitarios. Conclusiones: tras revisar diversas bibliografías en diversas bases de datos se propone reforzar una creciente cultura de seguridad clínica en los profesionales sanitarios, logrando el compromiso y la convicción de todos los profesionales implicados en la utilidad de la herramienta(AU)

ntroduction: The WHO develops strategies to reduce the adverse events to the patient that is going to be tapped with the aim of promoting the surgical patient's certainty; the various worldwide countries have extended the implementation of the list of verification of the certainty of surgery. Objective: To deepen knowledge and the conviction of the professionals in the identification of controls of certainty of the surgery for the prevention of damages to the surgical patient. Development: The adverse events are more frequent in the surgical patients than in give them any other specialty. The patients to the being tapped surgically, more music vulnerable to complications produced by professional errors. The fulfillment of protocols like the CHECK LIST guarantees the patient safety and it credits the good praxis for part of the sanitary professionals. Conclusions: It is proposed reinforcing an increasing culture of clinical certainty in the sanitary professionals after checking various bibliographies in various bases of data, achieving the commitment and the conviction of all of the professionals implicated in the utility of the too(AU)

[Results of an integral lifestyle modification program to reduce weight among overweight and obese women]. / Efectos de una intervención integral en la reducción de factores de riesgo cardiovascular en mujeres con sobrepeso u obesidad de la Región de Los Ríos.

BACKGROUND: In Chile, the Ministry of Health implemented an integral therapeutic program to reduce cardiovascular risk and increase physical activity (PA) among the population. AIM: To assess the effectiveness of the program in a group of overweight or obese adult women with a family history of Type 2 Diabetes and / or prehypertensive and / or prediabetes. MATERIAL AND METHODS: A group of 128 women aged 35 ± 10 years with a mean body mass index (BMI) of 33 kg/m2 were invited to participate in a program that lasted four months and included PA sessions and workshops with psychologists and nutritionists. Weight and waist circumference were measured at baseline and at four and six months of follow up. The blood glucose was measured at baseline and at 4 months, only in the affected income. RESULTS: At four months the reduction in weight and waist circumference observed, was around 2%, and at 6 months the reductions was around 3%. The largest reductions were observed at 6 months in obese patients ≥ 40 years. Women that were more compliant with PA sessions had a greater weight reduction. The blood glucose levels decreased significantly independent of the reduction of anthropometric parameters. CONCLUSIONS: The program is considered successful to reduce cardiovascular risk factors and increase the practice of PA. The intervention was especially effective in patients > 40 years possibly due to higher food education, maturity and responsibility to the intervention.

Efectos de una intervención integral en la reducción de factores de riesgo cardiovascular en mujeres con sobrepeso u obesidad de la Región de Los Ríos / Results of an integral lifestyle modification program to reduce weight among overweight and obese women

Background: In Chile, the Ministry of Health implemented an integral therapeutic program to reduce cardiovascular risk and increase physical activity (PA) among the population. Aim: To assess the effectiveness of the program in a group of overweight or obese adult women with a family history of Type 2 Diabetes and / or prehypertensive and / or prediabetes. Material and Methods: A group of 128 women aged 35 ± 10 years with a mean body mass index (BMI) of 33 kg/m2 were invited to participate in a program that lasted four months and included PA sessions and workshops with psychologists and nutritionists. Weight and waist circumference were measured at baseline and at four and six months of follow up. The blood glucose was measured at baseline and at 4 months, only in the affected income. Results: At four months the reduction in weight and waist circumference observed, was around 2 percent, and at 6 months the reductions was around 3 percent. The largest reductions were observed at 6 months in obese patients ≥ 40 years. Women that were more compliant with PA sessions had a greater weight reduction. The blood glucose levels decreased significantly independent of the reduction of anthropometric parameters. Conclusions: The program is considered successful to reduce cardiovascular risk factors and increase the practice of PA. The intervention was especially effective in patients > 40 years possibly due to higher food education, maturity and responsibility to the intervention.