Análisis preliminar de alimentos para la población vegana/vegetariana. ¿son buenos aportadores de minerales de interés nutricional? / Preliminary analysis of foods for the vegan/vegetarian population. Are they good suppliers of minerals of nutritional interest?

Resumen Introducción: recientemente, se ha evidenciado gran desarrollo de variados productos destinados a la población vegetariana/vegana. Sin embargo, su valor nutricional no ha sido estudiado en profundidad. El objetivo del presente estudio fue evaluar aporte potencial (AP) y porcentaje de cobertura de requerimientos diarios (%RD) de hierro, calcio y zinc de alimentos dirigidos a poblaciones adolescente y adulta vegetariana/vegana. Materiales y método: se analizaron cinco medallones (4 comerciales, 1 casero) y once bebidas (9 comerciales, 4 de ellas c/jugo frutal y 2 caseras) elaborados con materias primas vegetales. Se estableció el AP de Fe, Ca y Zn en los productos considerando su contenido y dializabilidad porcentual (D%). Se calculó, para una porción de alimento, el porcentaje de cobertura del requerimiento diario de estos minerales. Resultados: el contenido de los minerales en los medallones fue: [Fe] 1,64-4,21 mg%; [Ca] 104-213 mg% y [Zn] 0,53-3,57 mg%; en las bebidas se observó: [Fe] 0,24-2,39 mg%; [Ca] 71-214 mg% y [Zn] 0,18-0,79 mg%. La D% en medallones fue: Fe 7,3-11,9; Ca 10,2-18,2 y Zn 17,0-21,4 y para las bebidas, Fe 5,2-32,8; Ca 6,4-35,7 y Zn 5,9-33,9. El %RD para adolescentes, considerando una porción de medallones fue: Fe mujeres 3,0-9,0%; hombres 5,0-16%; Ca 0,7-6,8% y Zn 1,5-3,9% y para adultos fue: Fe mujeres 3,0-10%; hombres 7,0-20%; Ca 0,6-5,8% y Zn 2,0-5,1%. Al considerar las bebidas, el %RD para adolescentes fue: Fe mujeres 2,0-28%; hombres 4,0-53%; Ca 0,4-22% y Zn 1,3-9,5%. Para adultos fue: Fe mujeres 2,0-31%; hombres 5,0-64%; Ca 0,3-19% y Zn 1,8-12%. Conclusiones: en los medallones se observó bajo %RD para los minerales estudiados. Las bebidas con agregado de jugos de naranja o manzana aportaron cantidades significativas de hierro. El %RD para zinc y calcio de los dieciséis alimentos fue bajo (ambos grupos estudiados). Consecuentemente, para cubrir los requerimientos de estos minerales habría que combinar adecuadamente los alimentos que se consumen.

Abstract Introduction: recently, there has been great development of various products aimed at the vegetarian/vegan population. However, its nutritional value has not been studied in depth. The objective of this study was to evaluate potential intake (PI) and percentage of coverage of daily requirements (% RD) of iron, calcium and zinc from foods aimed at adolescent and adult vegetarian/vegan populations Materials and method: five medallions (4 commercial, 1 homemade) and eleven beverages (9 commercial, 4 of them with fruit juice and 2 homemade) made with vegetable raw materials were analyzed. The PI of Fe, Ca and Zn was established in the products considering their content and percentage dialyzability (D%). It was calculated, for a portion of food, the percentage of coverage of the daily requirement of these minerals. Results: the mineral content in the medallions was: [Fe] 1.64-4.21 mg%; [Ca] 104-213 mg% and [Zn] 0.53-3.57 mg%; in beverages it was observed: [Fe] 0.24-2.39 mg%; [Ca] 71-214 mg% and [Zn] 0.18-0.79 mg%. The D% in medallions was: Fe 7,3-11,9; Ca 10.2-18.2 and Zn 17.0-21.4 and for beverages, Fe 5.2-32.8; Ca 6.4-35.7 and Zn 5.9-33.9. The %RD for adolescents, considering a portion of medallions was: Fe women 3.0-9.0%; men 5.0-16%; Ca 0.7-6.8% and Zn 1.5-3.9% and for adults it was: Fe women 3.0-10%; men 7.0-20%; Ca 0.6-5.8% and Zn 2.0-5.1%. When considering beverages, the %RD for adolescents was: Fe women 2.0-28%; men 4.0-53%; Ca 0.4-22% and Zn 1.3-9.5%. For adults it was: Fe women 2.0-31%; men 5.0-64%; Ca 0.3-19% and Zn 1.8-12%. Conclusions: in the medallions, low % RD was observed for the minerals studied. Drinks with added orange or apple juices provided significant amounts of iron. The %RD for zinc and calcium of the sixteen foods was low (both groups studied). Consequently, to meet the requirements of these minerals, it would be necessary to properly combine the foods consumed.

Cybernetic governance of the Peruvian State: a proposal.

This paper aims to make a proposal to govern the Peruvian State under the umbrella of management cybernetics, following the paths of the viable system model (VSM), proposed by Prof. Stafford Beer, enriched with other soft and hard systemic methodologies and technologies, to cover the soft and hard issues that are part of the complex Peruvian reality at different levels of recursion. For doing this, four defined perspectives were adopted to understand the complexity of Peru: the sectoral view, the regions view, the river basins view and the macroregions view. Peru is seen as a system in focus, defining, for each of these four perspectives, the five systems that VSM has. The application of the VSM in each perspective serves to apply it in two modes: diagnosis and design, according to the respective perspective. Then an integrative analysis and reflection is done considering the four perspectives, to analyze the viability of the VSM approach in the governance of the Peruvian State to establish some conclusions and recommendations in relation to the proposal, appearing at the end of the paper.

Buenas prácticas de manufactura y microorganismos indicadores en sándwiches de verdura expendidos en el mercado central de abasto de Asunción, Paraguay (2014) / Good manufacturing practices and indicator microorganisms in vegetable sandwiches expended at the central supply market in Asunción, Paraguay (2014)

El objetivo de este estudio descriptivo y transversal fue describir la presencia de microorganismos indicadores y las BPM en los locales que producen sándwiches de verdura en el Mercado Central de Abasto de Asunción (MCAA) en el 2014. Se eligieron sándwiches de verduras debido a la materia prima cruda y mayonesa, a que no sufren tratamiento térmico y son de consumo masivo. Se elaboró una lista de verificación para las BPM según la FAO/OMS. Se estudiaron 20 muestras en 10 locales(2/local) para Recuento de Aerobios Mesófilos (RAM), coliformes totales, E. coli y S. aureus. El límite microbiológico fue dado por la Norma Sanitaria del Ministerio de Salud de Perú y la técnica utilizada fue el Recuento en Placa, utilizando placas de 3M PETRIFILM.El 90% de los 10 localestenía limpieza adecuada,todos refirieron lavadode las verduras previa utilización, para lo cual usaban agua de canilla (90%)o agua reutilizada (10%). El 70% de los manipuladores refirió lavadode manos previa manipulación y 90% después.El 80% de los locales refirió utilizar mayonesa comercial y el 30% la mantenía a temperatura ambiente durante todo el día.El 20% de los locales ofrecíaal día siguiente los sándwiches no vendidos. El 95% (19 de 20)de las muestras se considera microbiológicamente como “No Aptas” para el consumo, el 70% presentó recuentos mayores para RAM, 85% para coliformes, 30% para E. coli y 75% para S. aureus. Estos productos pueden ser considerados de riesgo para el consumo humano.

The objective of this cross-sectional descriptive study was to evaluate the presence of indicator microorganismsand to describe the Good Manufacturing Practices (GMP) in places producing vegetable sandwiches of the Central Supply Market of Asunción (MCAAfor its name in SpanishMercado Central de Abasto de Asunción)in 2014. Vegetable sandwiches were chosen for being of high risk, as they use raw materials and mayonnaise, they do not undergo heat treatment and are of massive consumption.For GMP, a checklist was prepared according to FAO / WHO. Twenty samples in 10 shops (2 samples per shop) were studied for Mesophilic Aerobic Count, total coliform counts, E. coli and S. aureus. Ninety percent of the 10 stores had adequate cleaning. Hundred percent claimed to wash the raw material (vegetables) before being used, 90% used tap water and 10% washed them with reused water. Seventy percent of the cooks washed their hands before preparing the sandwiches and 90% afterwards. Eighty percent of the stores used commercial mayonnaise and 30% keepthem at room temperature throughout the day. Twenty percent of the stores offered unsold sandwiches the next day.Of the 20 samples, 19 (95%) were considered microbiologically as "Not Apt" for consumption, 70% due to high Counting of Mesophilic Aerobes, 85% coliforms, 30% E. coli and 75% S. aureus. These products can be considered as a risk for human consumption.

Buenas Prácticas de Manufactura y Factores de Riesgo Durante la Manipulación de Alimentos en los Mercados Municipales del Departamento de Caaguazú (2015-2016)

Resumen La alimentación incide directamente en la salud humana. En los mercados se elaboran y expenden productos alimenticios de alta demanda y gran consumo. El objetivo de este trabajo fue describir las buenas prácticas de manufactura y los factores de riesgo durante la manipulación de alimentos en los Mercados Municipales del Departamento de Caaguazú, años 2015 y 2016. El estudio fue de tipo observacional descriptivo de corte transversal y prospectivo. La muestra quedó conformada por 5 mercados, en los cuales fueron seleccionados para participar del estudio 66 manipuladores de alimentos y 39 establecimientos gastronómicos. Para la recolección de datos relacionados con las BPM, se diseñó y validó una lista de verificación que contenía 176 variables agrupadas en 14 secciones, con el mismo instrumento también se identificaron los factores de riesgo. Los resultados arrojaron la siguiente información. Los factores de riesgo observados en los manipuladores de alimentos fueron: forma incorrecta como descongelan los alimentos con el 98,46% (n=64), prueban los alimentos de forma incorrecta el 85,25% (n=52) y el no uso del uniforme completo de color claro y limpio el 83,33% (n=55).En los establecimientos, los factores de riesgo observados fueron en mayor porcentaje fueron: la forma de disposición de la basura, lo realiza de forma incorrecta el 84,88% (n=37), no realizan el lavado de los abridores de lata entre cada uso, un 92,31% (n=36) y alimentos no almacenados por separado debidamente, el 92,31% (n=36). Se concluyó de manera general en los Mercados Municipales del Departamento de Caaguazú durante los años 2015 - 2016, no se conocían ni aplicaban las buenas prácticas de manufactura, siendo observados algunos factores de riesgo como fueron la formad de descongelar los alimentos, la forma en cómo prueban los alimentos, la forma de disposición de la basura y lavado de abridores de lata entre cada uso.

Abstract Food directly affects human health. In markets, high-demand and high-consumption food products are made and sold. The objective of this work was to describe good manufacturing practices and risk factors during food handling in the Municipal Markets of the Department of Caaguazú, in the years 2015 and 2016. The study was descriptive observational cross-sectional and prospective. The sample consisted of 5 markets, in which 66 food handlers and 39 gastronomic establishments were selected to participate in the study. For the collection of GMP-related data, a checklist was drawn up and validated containing 176 variables grouped into 14 sections, with the same instrument also identifying risk factors. The results showed the following information. The risk factors observed in food handlers were: incorrectly defrosted food with 98.46% (n = 64), incorrectly tested food 85.25% (n = 52) and non-use of the complete uniform of light and clean color 83.33% (n = 55). In the establishments, the observed risk factors were in greater percentage were: the form of disposition of the garbage, it performs incorrectly the 84, 88.3% (n = 36) and food not separately stored properly, 92.31% (n = 36) did not perform the washing of can openers between each use. It was concluded in general in the Municipal Markets of the Department of Caaguazú during the years 2015 - 2016, the good manufacturing practices were not known and applied, being observed some risk factors such as the form of thawing the food, the way in which test foods, how to dispose of trash and wash can openers between each use.

Buenas prácticas de manufactura en comedores del mercado central de abasto de Asunción, Paraguay / Good manufacturing practices in canteens of the central market of abasto of Asunción, Paraguay

Las Buenas Prácticas de Manufactura (BPM) constituyen un "conjunto de principios y recomendaciones técnicas que se aplican durante el procesamiento de los alimentos para garantizar su inocuidad y su aptitud" y son de obligado cumplimiento. El sándwich de verdura es de alto riesgo, utiliza materias primas crudas y mayonesa, no sufre cocción y es de consumo masivo. El objetivo fue describir las BPM en comedores del Mercado Central de Abasto de Asunción, Paraguay que producen sándwiches de verduras. Estudio prospectivo, descriptivo, transversal, de muestreo por conveniencia. Se incluyeron 50 comedores del Mercado Central de Abasto que producen sándwiches de verduras y accedieron a participar del estudio. La evaluación fue con una lista de verificación basada en el Codex Alimentarius (FAO/OMS). El 60% no presentó buena estructura edilicia, y en el 32% de los comedores se observaron animales o vectores. El 54% poseía basureros cerca de los alimentos, 46% con tapa. El 42% no adquiría la materia prima de proveedores autorizados, y 30% utilizaba agua reciclada. El 10% no lavaba los productos de ninguna forma, el 86% de los manipuladores refirió lavarse las manos antes y el 88% después de manipular los alimentos. El 82% tenía el pelo recogido y uñas limpias y cortas, y el 46% utilizaba accesorios (anillos, relojes y pulseras). En el 42% la misma persona manipulaba los alimentos y cobraba. El 20% recibió capacitación y el 43% fue inspeccionado por la Municipalidad de Asunción. Los establecimientos que procesan alimentos deben implementar las BPM para reducir riesgos.

Good Manufacturing Practice or GMP is "a set of principles and technical recommendations that are applied throughout the processing of food to ensure its safety and aptitude" and they are mandatory. The objective was to describe the GMP in the kitchens of the canteens of the Central Market of Abasto of Asunción, Paraguay during 2014. The research was descriptive, transversal, and prospective and applied a nonprobabilistic and convenience sampling. The populations were the kitchens in the Central Market of Abasto which prepare vegetables sandwiches and the ones that agreed to participate in the study. Vegetables sandwiches present a higher contamination risk, because of their raw ingredients, including mayonnaise and do not go through high temperatures, is highly sold and consumed. The evaluation was carried on with a check list based on the Codex Alimentarius (FAO/WHO). Sixty percent did not have the adequate facilities and animals or vectors (32%) were seen at the place. Fifty four percent had trash cans near food, 46% of them had lids. Forty two percent did not purchase raw materials from approved suppliers, 30% used recycled water, 10% did not wash products in any way and 86% of handlers washed their hands before touching food and 88% after. Eighty two percent had their hair tied up and fingernails clean and short and 46% used accessories (rings, watches and bracelets). In 42% the same person manipulated the food and the money. Twenty percent received training and 43% were inspected by the Municipality of Asunción. Food processing establishments must implement GMP to reduce risks.

Timing of interventions in the delivery room: does reality compare with neonatal resuscitation guidelines?

OBJECTIVE: To determine the proportion of infants who had the tasks recommended in the neonatal resuscitation guidelines performed within 30 and 60 seconds of birth, and the time taken to perform each task. STUDY DESIGN: From video recordings in delivery rooms, we determined the time from birth and arrival on a resuscitation table to warm, assess heart rate (HR), attach an oximeter, and provide respiratory support for each infant. We determined the proportion of infants who had these tasks completed by 30 and 60 seconds, and the median time taken to perform each task. RESULTS: We reviewed and analyzed data from 189 infants (median gestational age, 29 weeks [IQR, 27-34 weeks]; median birth weight, 1220 g [IQR, 930-2197 g]). Twelve infants (6%) were not on the resuscitation table within 30 seconds of birth. Less than 10% of infants were placed in polyethylene bags or had their HR determined by 30 seconds. By 60 seconds, 48% were in polyethylene bags, 33% had their HR determined, 38% received respiratory support, and 60% had an oximeter attached. The median time taken to perform all tasks was greater than that recommended in the guidelines. CONCLUSION: Most newborns were not managed within the time frame recommended in resuscitation guidelines. The recommended 30- and 60-second intervals may be too short.

Long-term outcomes of pediatric sinus bradycardia.

OBJECTIVES: To delineate the long-term outcomes and mechanisms of pediatric sinus bradycardia. STUDY DESIGN: Participants with sinus bradycardia who were identified from a survey of 432,166 elementary and high school students, were enrolled 10 years after the survey. The clinical course, heart rate variability, and hyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4) gene were assessed. RESULTS: A total of 104 (male:female was 60:44; prevalence, 0.025%) participants were observed to have sinus bradycardia at age 15.5 ± 0.2 years with a mean heart rate of 48.4 ± 0.4 beats per minute; 86 study participants (83%) responded to clinical assessment and 37 (36%) underwent laboratory assessment. Athletes composed 37.8% of the study participants. During the extended 10-year follow-up, 15 (17%) of the participants had self-limited syncopal episodes, but none had experienced life-threatening events. According to Holter recordings, none of the participants had heart rate <30 beats per minute or a pause longer than 3 seconds. Compared with 67 age- and sex-matched controls, the variables of heart rate based on the spectral and time domain analysis of the participants with sinus bradycardia were all significantly higher, indicating higher parasympathetic activity. The results of mutation analysis were negative in the HCN4 gene in all of our participants. CONCLUSIONS: The long-term outcomes of the children and adolescents with sinus bradycardia identified using school electrocardiographic survey are favorable. Parasympathetic hyperactivity, instead of HCN4 gene mutation, is responsible for the occurrence of sinus bradycardia.

Conhecimento sobre DST entre policiais militares do 10° BPM do estado do Rio de Janeiro / Knowledge about STDs among Military Police of the 10th BPM State of Rio de Janeiro

as DST são um sério problema de saúde pública, causando várias complicações, como infertilidade, câncer de colo de útero, câncer de pênis,além de vários problemas psicossociais. Objetivo: verificar o conhecimento de DST e fatores de risco para aquisição de DST entre policiais militares do10o Batalhão de Polícia Militar do Estado do Rio de Janeiro (10o BPM-RJ). Métodos: estudo epidemiológico com delineamento transversal com aplicaçãode questionário autoaplicável, individual e anônimo. População-alvo: policiais militares do 10o BPM, situado em Barra do Piraí, RJ. O questionário foiconstituído de 24 perguntas que abordavam dados sociodemográficos (como idade, sexo, estado civil, patente) e de comportamento sexual/práticas de risco(tipo de parceria, práticas sexuais, uso de preservativo, número de parceiros, frequência das relações, uso de bebidas alcoólicas, drogas ilícitas)...

Behavioral Perspective Model: Conceptual Analysis and Review / Modelo de la perspectiva conductual: análisis y revisión conceptual

The purpose of this study was to analyze and review the conceptual categories of the Behavioral Perspective Model (BPM), taking into account the importance of conceptual activity has for analytical purposes which the sciences that study consumer behavior pursue. From the BPM model theoretical identification and contextualization of its main epistemological assumptions, we proceeded to identify publications that present the model and its conceptual categories, which were discussed based on the principles of Harzem and Miles (1978) on conceptual analysis and review. This analysis allowed the identification of logical and methodological weaknesses within the approach, being particularly salient the use of the term reinforcement beyond its legitimate use on behavior analysis, inconsistency in the analysis of transaction costs and linearity which does not allow a historical analysis of the interactions. With these findings we propose a reformulation of the model to overcome the specified difficulties, as well as the incorporation of different findings from the field from other disciplines.

El propósito de esta investigación fue analizar y revisar las categorías conceptuales del Modelo de la Perspectiva Conductual (BPM), teniendo en cuenta la importancia que la actividad conceptual tiene para los propósitos analíticos que persiguen las ciencias que estudian el comportamiento del consumidor. A partir de la identificación teórica del modelo BPM y la contextualización de sus supuestos epistemológicos principales, se procedió a identificar las publicaciones que presentan el modelo y sus categorías conceptuales, las cuales se discutieron con base en los postulados de Harzem y Miles (1978) sobre análisis y revisión conceptual. Este análisis permitió identificar inconsistencias lógicas y metodológicas al interior del acercamiento, siendo particularmente saliente el uso del término reforzamiento más allá de sus usos legítimos en análisis del comportamiento, la incongruencia en el análisis del costo de las transacciones y una linealidad que no permite un análisis histórico de las interacciones. Con estos hallazgos se propone una reformulación del modelo que permita la superación de las dificultades especificadas, como también la incorporación de diferentes hallazgos del campo provenientes de otras disciplinas.

Nuevos enfoques de las buenas prácticas de Manufactura / Good manufacturing practices new approaches

Durante los últimos años, el trabajo en Buenas Prácticas de Manufactura (bpm), además de contribuir a mejorar la calidad de los productos farmacéuticos disponibles en el mercado, ha permitido realizar un avance importante en la interpretación conceptual y en la aplicación práctica del verdadero significado del aseguramiento de la calidad en la industria farmacéutica. En ese sentido, este artículo analiza los aportes que sobre este tema han tenido las buenas prácticas de ingeniería, el desarrollo de producto, los programas de acciones correctivas y acciones preventivas, la gestión del riesgo en calidad, el control de procesos productivos en tiempo real y el sistema de gestión de la calidad para la industria farmacéutica. Sin duda, su adopción, que en la mayoría de los casos no corresponde a una exigencia explícita de la guía de bpm y que supone una inversión mayor de recursos, ofrece claros beneficios organizacionales y aporta evidencia para fortalecer la confianza, especialmente de las autoridades reguladoras, del cumplimiento del compromiso con la calidad que manifiesta una empresa determinada.

During the previous years, the Good Manufacturing Practices (gmp) work, besides contributing in improving the pharmaceutical products quality, has allowed an important progress in both the understanding and the practical application in the real meaning of the quality assurance in the pharmaceutical industry. As a contribution to this issue, this document studies the contributions of the good engineering practices, the product development, the corrective and preventive action system, the quality risk management, the process analytical technology and the pharmaceutical quality system. The implementation of these concepts, that in the majority of cases are not explicit gmp guide requirements, could suppose spending more money from the firm. However, on the contrary, it would give obvious benefits and contribute to have evidence, especially for the competent national authorities, about the fulfillment quality police implementation.