Biased perception of the environmental impact of everyday behaviors.

Despite our concern about climate change, certain psychological barriers hinder the adoption of a pro-environmental lifestyle. In the present study (n = 186), we analyzed the participants' estimates of the environmental impact of their lifestyles, compared to their moral standards and the perceived normative impact. Results show that individuals recognize their lifestyle is more unsustainable than what is generally acceptable, yet they consider the lifestyle of others to be even more harmful. Furthermore, we studied the role of compensatory green beliefs on the biases in the estimated environmental impacts. The results showed that individuals tend to consider that pro-environmental behaviors have a neutral environmental impact. Thus, our research suggests the existence of a bias in individuals' perception of environmental impacts.

Impact of Contact With Nature on the Wellbeing and Nature Connectedness Indicators After a Desertic Outdoor Experience on Isla Del Tiburon.

Nature connectedness is determined by the representation individuals have about themselves within nature. This concept is often studied in relation to the direct contact individuals have with natural environment, which according to some studies have demonstrated to generate positive effects by fostering a feeling of connecting and bonding with nature, as well as improving their wellbeing. The main focus of this study was to calculate and assess the relation between Nature Connectedness and wellbeing of participants. The methodological approach of this research reaches quantitative data comparing results obtained from both samples, as well as correlations between the variables. The sample for this study was composed by two groups of university students (M = 25 years old). Both contrast group (n = 32) and experience group (n = 29) filled the questionnaire in two separate moments and in different environments. First data collection moment for both groups was held inside a university classroom. A second moment of data collection was carried out after a month from the first application, having the contrast group answer the questionnaire on a classroom again whilst the experience group responded it during an excursion to Isla Del Tiburon in Northwestern Mexico after performing some recreational activities being totally immersed in a local desertic environment. Questionnaire was composed by a 6 point Likert type scale measuring Nature Connectedness through concepts such as Nature relatedness and Love and care for the natural, as well as Subjective and Psychological Wellbeing of participants. Results show that both wellbeing and Nature Connectedness are positively influenced by performing activities out in the natural environment. This work was also conducted in response to the need to understand the full extent of Contact and Connectedness to nature, carrying out an exploratory study in desertic settings when much of the early work centers around the study of these variables in green nature environments.

Judging Pharmaceutical Environmental Risk by its Cover? The Effects of Prescription Medication and Disease Severity on Environmental Risk Perception.

Recent wastewater analyses performed in care homes for the elderly showed high levels of water pollution resulting from pharmaceutical waste. The way people perceive the environmental risk of pharmaceuticals can contribute to reversing this problem, but the factors that influence risk perception remain relatively unknown. The aims of the study are two-fold. We first focused on exploring the levels of knowledge regarding environment/water pollution due to pharmaceutical residues from the groups responsible for prescribing (health professionals), handling (staff), and consuming pharmaceuticals (residents) in care homes for the elderly. Second, we assessed the environmental risk perception of pharmaceuticals based on two main factors: prescription medication (nonprescribed versus prescribed) and disease severity (milder versus severe disease), accounting for their level of knowledge (deficit versus sufficiency of knowledge). The study was designed based on correlational research. Data were collected in homes for the elderly located in three Southwestern European countries (N = 300), using self-report surveys. Current knowledge was perceived to be low and the need to know more was perceived to be high, across all groups. As hypothesized, results indicated that to assess the environmental risk, participants made use of information that was unrelated to pharmaceutical persistence, bioaccumulation, and toxicity (PBT). Prescribed pharmaceuticals and/or medication used to treat severe diseases were perceived as being more hazardous for the environment. Simple main effects analysis comparing between knowledge levels confirmed that this effect occurred mostly when participants had knowledge deficit for disease severity but not for prescription medication. These misconceptions might discourage taking an active role in reducing the impact of pharmaceutical residues in the environment.

Development of simple and sensitive score to assess the risk of pneumonia in Covid-19 patients

ABSTRACT Background: Severe pneumonia is the most common cause of intensive care unit (ICU) admission and death due to novel coronavirus (SARS-CoV-2) respiratory disease (COVID-19). Due to its rapid outbreak, units for the evaluation of febrile patients in the pre-hospital setting were created. Objective: The objective of the study was to develop a sensitive and simple tool to assess the risk of pneumonia in COVID-19 patients and thus select which patients would require a chest imaging study. Materials and Methods: We conducted a cross-sectional study in a cohort of individuals with suspected COVID-19 evaluated in a public academic healthcare center in Buenos Aires city. All adult patients with positive RT-PCR assay for SARS-COV2 between April 24 and May 19 of 2020 were included in the study. Pneumonia was defined as the presence of compatible signs and symptoms with imaging confirmation. Univariate and multivariate logistic regression was performed. A risk indicator score was developed. Results: One hundred and forty-eight patients were included, 71 (48%) received the diagnosis of pneumonia. The final clinical model included four variables: age ≥ 40 years, cough, absence of sore throat, and respiratory rate ≥ 22. To create the score, we assigned values to the variables according to their ORs: 2 points for respiratory rate ≥ 22 and 1 point to the other variables. The AUC of the ROC curve was 0.80 (CI 95% 0.73-0.86). A cutoff value of 2 showed a sensitivity of 95.7% and a specificity of 43.24%. Conclusion: This sensible score may improve the risk stratification of COVID-19 patients in the pre-hospital setting. (REV INVEST CLIN. 2021;73(1):52-8)

Development of Simple and Sensitive Score to Assess the Risk of Pneumonia in COVID-19 Patients.

BACKGROUND: Severe pneumonia is the most common cause of intensive care unit (ICU) admission and death due to novel coronavirus (SARS-CoV-2) respiratory disease (COVID-19). Due to its rapid outbreak, units for the evaluation of febrile patients in the pre-hospital setting were created. OBJECTIVE: The objective of the study was to develop a sensitive and simple tool to assess the risk of pneumonia in COVID-19 patients and thus select which patients would require a chest imaging study. MATERIALS AND METHODS: We conducted a cross-sectional study in a cohort of individuals with suspected COVID-19 evaluated in a public academic healthcare center in Buenos Aires city. All adult patients with positive RT-PCR assay for SARS-COV2 between April 24 and May 19 of 2020 were included in the study. Pneumonia was defined as the presence of compatible signs and symptoms with imaging confirmation. Univariate and multivariate logistic regression was performed. A risk indicator score was developed. RESULTS: One hundred and forty-eight patients were included, 71 (48%) received the diagnosis of pneumonia. The final clinical model included four variables: age >- 40 years, cough, absence of sore throat, and respiratory rate >- 22. To create the score, we assigned values to the variables according to their ORs: 2 points for respiratory rate >- 22 and 1 point to the other variables. The AUC of the ROC curve was 0.80 (CI 95% 0.73-0.86). A cutoff value of 2 showed a sensitivity of 95.7% and a specificity of 43.24%. CONCLUSION: This sensible score may improve the risk stratification of COVID-19 patients in the pre-hospital setting.

Lay people and experts' risk perception of pharmaceuticals in the environment in Southwestern Europe.

This study aims to contribute to the risk management of pharmaceuticals in the environment, illustrating risk perceptions of lay people and experts from Southwestern Europe (Portugal, Spain, and France). The psychometric paradigm was applied to assess risk regarding four hazards: pharmaceuticals in the environment (i.e., broadly framed), pharmaceuticals in treated wastewater, pharmaceuticals in drinking water, and pharmaceuticals in crops. Two factors explained most of the variance of risk assessments: dread and unknown. The dread factor combined immediacy and severity of effects, and the old nature of hazards. Pharmaceuticals in crops and drinking water scored higher in this factor, as did experts and French respondents. The unknown factor differentiated between the assessments of lay people and experts. Lay people assessed the hazards as being more known by those who were exposed but less known by science; and exposure was perceived as more voluntary and the risk as more controllable. Even though pharmaceutical residues are present in much higher concentrations in treated wastewater, risk assessments were overall higher for drinking water and crops. Moreover, data also revealed risk management preferences: whereas lay people preferred technological and awareness-type measures, experts preferred measures to improve the disposal of pharmaceutical waste and health-type measures.

The importance of household pharmaceutical products disposal and its risk management: Example from Southwestern Europe.

The presence of pharmaceuticals in the environment is an emergent unknown environmental problem, linked to increased production and consumption of pharmaceuticals and, as such, understanding risk perception is fundamental. This study focuses on exploring causes (trust and knowledge) and effects (intention and proper individual disposal of pharmaceutical leftovers) of environmental and health risk perception. Survey data was collected in Portugal, Spain, and France (sample of 509 individuals). Data illustrated that in France, where the quantity of recycled pharmaceuticals is much higher, respondents reported a higher need for knowledge, but not a higher risk perception nor self-reported behaviour. Although previous research illustrates that higher trust correlates with lower risk perception, we found a positive correlation, which highlights the need to comprehend these variables in emergent risks. Results further confirmed a hypothesized moderated mediation model to explain proper disposal behaviour. We found an indirect effect of risk perception on behaviour through intention, which was stronger for participants with higher environmental identity. Understanding the causes and effects of risk perception of pharmaceuticals in the environment thereby contributes to improve pharmaceutical waste management processes and to promote the proper disposal of pharmaceuticals.

Mesa 1: actividad física y diabetes mellitus. Aspectos generales / Table1: diabetes mellitus and physical activity. General aspects

Se define como actividad física (AF) a cualquier movimiento corporal que realice el músculo esquelético y que resulte en gasto energético superior al basal. El ejercicio es una subcategoría de AF planeada, estructurada y repetitiva, y tiene como objetivo mejorar o mantener la aptitud física. El ejercicio crónico genera adaptaciones metabólicas favorables para el tratamiento de la diabetes, mejorando la función mitocondrial e incrementando la expresión de los GLUT-4. A su vez, la AF ayuda al control del perfil lipídico y la presión arterial y puede mejorar el bienestar psicológico, la calidad de vida y la depresión en individuos con diabetes mellitus tipo 2 (DM2). La condición o aptitud física es el conjunto de atributos que le permiten a una persona realizar actividad física en forma eficiente. La condición física cardiorrespiratoria (CCR) se define como la capacidad de los sistemas circulatorio, respiratorio y vascular de suministrar oxígeno a los músculos durante una actividad física sostenida. El entrenamiento intervalado de alta intensidad (HIIT) mejoraría la CCR de forma superior al ejercicio aeróbico tradicional. Por otro lado, la termogénesis de la actividad no ejercicio (NEAT) se refiere a todo gasto de energía que se produce por actividades distintas al ejercicio, como cocinar. Pequeñas ráfagas de NEAT mejoran el manejo de la insulina y la lipólisis

Categorización de los objetos que forman parte del Extended Self, y sus discursos asociados / Categorization of objects that are part of the extended self, and its associated discourses

Resumen La personalización del espacio se construye con las claves que el propietario distribuye en el espacio. Estas claves, mayoritariamente objetos, forman parte del Extended Self. Para comprobar si existe un discurso diferenciado según la categoría a la que pertenecen los objetos de los dormitorios, se realizaron tres estudios. Tras obtener una lista de los objetos más representativos, en el siguiente estudio los participantes clasificaron bajo su criterio estos objetos. Un análisis de cluster mostró dos categorías: funcional y simbólico. Finalmente, un análisis de contenido de las razones de selección de los objetos mostró discursos diferenciados para cada categoría. Los resultados confirman que los objetos se organizan en funcional y simbólico, en donde se obtienen discursos diferenciados según la categoría a la que pertenecen.

Abstract Personalization of space is constructed through the cues that the owner leaves in the space. These cues, mostly objects, are also a basic part of the extended self. To check if there is a differentiate discourse consistent with the categories in which the objects belong, three studies are carried out. After obtaining a list of the most representative, in the subsequent study the participants short these objects using their own criteria. A Cluster analysis showed two categories, Functional and Symbolic. Finally, a content analysis about the reasons of participants to choose each object showed differentiated discourses for each category. These results confirm the objects are organized into Functional and Symbolic, producing differentiated discourses. depending on the category they belong.

Pharmaceuticals released from senior residences: occurrence and risk evaluation.

One of the main pursuits, yet most difficult, in monitoring studies is to identify the sources of environmental pollution. In this study, we have identified health-care facilities from south European countries as an important source of pharmaceuticals in the environment. We have estimated that compounds consumed in by the elderly and released from effluents of senior residences can reach river waters at a concentration higher than 0.01 µg/L, which is the European Medicines Agency (EMA) threshold for risk evaluation of pharmaceuticals in surface waters. This study has been based on five health institutions in Portugal, Spain, and France, with 52 to 130 beds. We have compiled the pharmaceuticals dispensed on a daily base and calculated the consumption rates. From 54.9 to 1801 g of pharmaceuticals are consumed daily, with laxatives, analgesics, antiepileptics, antibiotics, and antidiabetic agents being the main drug families administered. According to excretion rates, dilution in the sewerage system, and elimination in wastewater treatment plants, macrogol, metformin, paracetamol, acetylcysteine, amoxicillin, and gabapentin, among others, are expected to reach river waters. Finally, we discuss the risk management actions related to the discharge of pharmaceuticals from senior residences to surface waters.

Insulinazación oportuna en el primer nivel de atención / Insulinization in the First Level of Care

La DMT2 constituye en Argentina un problema de salud pública de gran relevancia dada su elevada morbimortalidad y gran carga socioeconómica; la diabetes es responsable de casi el 50% de las amputaciones no traumáticas de miembros inferiores, una importante proporción de los infartos agudos de miocardio, accidentes cerebrovasculares y enfermedad renal crónica en diálisis, constituyendo una de las principales causas de ceguera en adultos. El impacto socioeconómico negativo de la diabetes se debe a su prevalencia elevada y también a su muy frecuente asociación con otros factores de riesgo cardiovasculares (FRCV) como sobrepeso/ obesidad, dislipidemia e hipertensión arterial, sumado al pobre grado de control de la hiperglucemia.

Lupus eritematoso sistémico activo, síndrome deactivación macrofágica y sepsis / Active systemic lupus erythematosus, macrophage activation syndrome and sepsis

El síndrome de activación macrofágica (SAM) es una entidad poco frecuente y grave, caracterizadapor una excesiva activación y proliferación de macrófagos y linfocitos T. Los factoresdesencadenantes son las infecciones, drogas, enfermedades malignas y autoinmunes. Ellupus eritematoso sistémico frecuentemente se asocia al SAM. En la práctica clínica, eldiagnóstico diferencial entre lupus eritematoso sistémico activo, SAM e infección es ungran desafío para el médico internista. Esto se debe a que los signos, síntomas y datos delaboratorio de estas entidades se superponen. El propósito de nuestro trabajo es el reportarlos casos de 2 pacientes con lupus eritematoso sistémico activo, SAM y sepsis...

Macrophage activation syndrome (MAS) is a rare and severe entity characterized by excessive activation and proliferation of macrophages and T-lymphocytes. The usual triggers are infections, drugs, malignancy and autoimmune diseases. Systemic lupus erythematosus is frequently associated with MAS. In clinical practice, differential diagnosis between active systemic lupus erythematosus, MAS and an infection is a great challenge for the internist. This happens because signs, symptoms and laboratory data from these illnesses overlap to a large degree. The purpose of this paper is to present a report on two patients with active systemic lupus erythematosus, MAS, and sepsis...