Monitoring health and health behaviors among adolescents in Central Catalonia: DESKcohort protocol / Monitorización de la salud y los comportamientos de salud entre los adolescentes de la Cataluña Central: Protocolo DESKcohort

El objetivo de este estudio prospectivo de cohortes (proyecto DESKcohort) es describir y monitorizar la salud, los comportamientos de salud y sus factores asociados en los adolescentes de entre 12 y 19 años escolarizados en centros de Educación Secundaria Obligatoria o secundaria posobligatoria de la Cataluña Central, considerando los determinantes sociales de la salud. La encuesta DESKcohort se realiza bianualmente, entre los meses de octubre y junio, y el proyecto lleva 3 años en marcha. Se ha entrevistado a 7319 y 9265 adolescentes en los cursos 2019/20 y 2021/22, respectivamente. Respondieron un cuestionario creado por un comité de expertos, que incluía las siguientes variables: sociodemográficas, salud física y mental, alimentación, actividad física, ocio y movilidad, consumo de sustancias, relaciones interpersonales, sexualidad, uso de pantallas y entretenimiento digital, y juegos de azar. Los resultados son presentados a los centros educativos, las diputaciones, los municipios y las entidades sanitarias y del tercer sector para planificar, implementar y evaluar acciones de prevención y promoción de la salud que aborden las necesidades identificadas.(AU)

The objective of the prospective cohort study (the DESKcohort project) is to describe and monitor health, health behaviors, and their related factors among 12 and 19-year-old adolescents schooled at centers of Compulsory Secondary Education or post-compulsory secondary education in Central Catalonia, considering social determinants of health. The DESKcohort survey is administered biannually between the months of October and June, and the project has been running for three years. We have interviewed 7319 and 9265 adolescents in the academic years 2019/20 and 2021/22, respectively. They responded a questionnaire created by a committee of experts, that included the following variables: sociodemographic factors, physical and mental health, food, physical activity, leisure and mobility, substance use, interpersonal relationships, sexuality, screen use and digital entertainment, and gambling. The results are presented to educational centers, county councils, municipalities, and health and third sector entities to plan, implement, and evaluate prevention and health promotion actions that address the identified needs.(AU)

Monitoring health and health behaviors among adolescents in Central Catalonia: DESKcohort protocol.

The objective of the prospective cohort study (the DESKcohort project) is to describe and monitor health, health behaviors, and their related factors among 12 and 19-year-old adolescents schooled at centers of Compulsory Secondary Education or post-compulsory secondary education in Central Catalonia, considering social determinants of health. The DESKcohort survey is administered biannually between the months of October and June, and the project has been running for three years. We have interviewed 7319 and 9265 adolescents in the academic years 2019/20 and 2021/22, respectively. They responded a questionnaire created by a committee of experts, that included the following variables: sociodemographic factors, physical and mental health, food, physical activity, leisure and mobility, substance use, interpersonal relationships, sexuality, screen use and digital entertainment, and gambling. The results are presented to educational centers, county councils, municipalities, and health and third sector entities to plan, implement, and evaluate prevention and health promotion actions that address the identified needs.

Un sistema de vigilancia de salud pública para el cambio climático en las ciudades / A public health surveillance system applied to climate change for cities

Se presenta una primera propuesta de sistema de vigilancia de salud pública aplicado al cambio climático en el contexto urbano, y el proceso que llevó a su definición. Tras varios años de seguimiento de los diversos aspectos del cambio climático y de su impacto, desde los servicios de salud pública de Barcelona se formuló una propuesta preliminar y se reunió un grupo de trabajo de personas expertas que discutieron y valoraron su contenido. Se partió de cuatro categorías de componentes: datos de clima, impactos en salud del cambio climático y sus determinantes, contribuciones de la ciudad a la mitigación (especialmente con cobeneficios para la salud) y acciones para reducir la vulnerabilidad ante eventos extremos. Se desglosaron en 12 componentes, con indicadores para cada uno. El esquema se refinó con aportaciones posteriores y se ha incorporado al trabajo de los servicios de salud pública de la ciudad implicados en este campo. (AU)

This paper makes a first proposal for a public health surveillance system for climate change in cities, and describes the process that led to its definition. After several years of monitoring different aspects related to climate change and its impact, the public health services of Barcelona made a preliminary proposal and gathered a working group of experts to discuss and review it. Four categories of components were defined: climate data, health impacts of climate change and its determinants, contributions of the city to mitigation (especially those with health co-benefits), and actions to reduce vulnerability to extreme events. They were broken in twelve components, with indicators for each. The proposal was further refined with subsequent reviews, and is being used by the city public health services involved in this field. (AU)

[A public health surveillance system applied to climate change for cities]. / Un sistema de vigilancia de salud pública para el cambio climático en las ciudades.

This paper makes a first proposal for a public health surveillance system for climate change in cities, and describes the process that led to its definition. After several years of monitoring different aspects related to climate change and its impact, the public health services of Barcelona made a preliminary proposal and gathered a working group of experts to discuss and review it. Four categories of components were defined: climate data, health impacts of climate change and its determinants, contributions of the city to mitigation (especially those with health co-benefits), and actions to reduce vulnerability to extreme events. They were broken in twelve components, with indicators for each. The proposal was further refined with subsequent reviews, and is being used by the city public health services involved in this field.

¿Es la atención primaria de salud integral parte de la respuesta a la pandemia de Covid-19 en Latinoamérica? / Is comprehensive primary health care part of the response to the COVID-19 pandemic in Latin America? / A atenção primária à saúde integral é parte da resposta à pandemia de Covid-19 na América Latina?

Resumen América Latina se ha convertido en uno de los epicentros de la pandemia de Covid-19, con una crisis sanitaria y humanitaria. El objetivo del artículo es analizar las medidas para enfrentar la pandemia en países de la Región y el rol de la Atención Primaria de Salud, discutiendo obstáculos y potencialidades. Son analizados los casos de Bolivia, Brasil, Chile, Colombia, Cuba, Uruguay y Venezuela. Los siete países adoptaran medidas de aislamiento social de diferentes alcances, con grados distintos de sostenibilidad. El énfasis de las respuestas estuvo más en la atención hospitalaria que en la vigilancia de la salud, identificación de casos y contactos y disposición de condiciones adecuadas para el confinamiento. En casi todos los países, se subestimó la capacidad de los servicios de atención primária en el territorio. No obstante, iniciativas de enfoque territorial y comunitario buscaron integrar la vigilancia de la salud con actividades de promoción, prevención y cuidado, aunque con alcance parcial. En este contexto la Atención Primaria Integral e integrada toma nuevo sentido y reclama desarrollos que contribuyan a recobrar el equilibrio entre sociedad y medio ambiente. Es necesario repensar los sistemas de salud y la importancia de la atención primaria de salud integrada e integral.

Abstract Latin America has become one of the epicenters of the COVID-19 pandemic, with a health and humanitarian crisis. The objective of the article is to analyze the strategies implemented by countries in the Region to face the pandemic and the role of Primary Health Care, considering obstacles and potential. The cases of Bolivia, Brazil, Chile, Colombia, Cuba, Uruguay and Venezuela were analyzed. The seven countries have adopted diverse social distancing strategies with varying degrees of sustainability. The responses emphasized hospital care more than surveillance, case identification, contact tracking, and enabling adequate conditions for isolation. In almost all cases studied, the capacity of primary care services in the territory was underestimated. Even so, primary care initiatives with a territorial and community focus sought to integrate health surveillance with promotion, prevention and care, despite partial implementation. In this context, comprehensive and integrated primary care takes on new meaning and requires new developments in order to contribute to the recovery of the balance between society and the environment. The pandemic showed the need to rethink health care systems and the importance of primary care for comprehensive and integrated health.

Resumo A América Latina tornou-se um dos epicentros da pandemia de Covid-19, com uma crise sanitária e humanitária. O objetivo do artigo é analisar as estratégias implementadas por países da Região para enfrentar a pandemia e o papel da Atenção Primária à Saúde, ponderando obstáculos e potencialidades. Foram analisados os casos de Bolívia, Brasil, Chile, Colômbia, Cuba, Uruguai e Venezuela. Os sete países adotaram estratégias de distanciamento social diversas com diferentes graus de sustentabilidade. As respostas enfatizaram mais a assistência hospitalar do que a vigilância, a identificação de casos, o rastreamento dos contatos e a viabilização de condições adequadas para isolamento. Em quase todos os casos estudados, foi subestimada a capacidade dos serviços de atenção primária no território. Ainda assim, iniciativas de atenção primária com enfoque territorial e comunitário buscaram integrar a vigilância à saúde com a promoção, prevenção e cuidado, apesar de implantação parcial. Nesse contexto, uma atenção primária integral e integrada adquire novo significado e requisita novos desenvolvimentos de forma a contribuir para a recuperação do equilíbrio entre a sociedade e o meio ambiente. A pandemia mostrou a necessidade de repensar os sistemas de atenção à saúde e a importância da atenção primária à saúde integral e integrada.

Reflexões sobre o uso do big data em modelos preditivos de vigilância epidemiológica no Brasil / Reflections on he use of big data in predictive models for epidemiological surveillance in Brazil / Reflexiones sobre el uso de macrodatos en modelos predictivos de vigilancia epidemiológica en Brasil

Objetivo: discutir as implicações bioéticas a partir do anúncio da Saúde Digital por parte da Organização Mundial da Saúde e do uso do big data na produção de sistemas preditivos de vigilância em saúde no Brasil. Metodologia: realizou-se revisão narrativa a partir da busca de artigos nas plataformas Scielo, Bireme, Jstor e na página da Organização Mundial da Saúde e do Ministério da Saúde do Brasil, com os descritores big data, bioética e ética, de maio a julho de 2020. Resultados:foram evidenciados limites no uso do big data como ferramenta de vigilância epidemiológica preditiva, notadamente com o seu uso durante a pandemia de Covid-19, apesar de justificável a partir da teoria da bioética da proteção e da ética da saúde pública. Os maiores limites observados foram ausência de legislação de proteção de dados adequada e viés dos dados obtidos. Conclusão: para análise dos impactos bioéticos do uso do big data na medicina do futuro é imprescindível aprofundar a discussão sobre os possíveis impactos que o uso dessas tecnologias pode gerar na vida em sociedade, com ênfase no desenvolvimento do capitalismo de vigilância, na interferência na vida social e no acirramento das desigualdades regionais.

Objective: to discuss the bioethical implications from the announcement of Digital Health by the World Health Organization and the use of big data in the production of predictive health surveillance systems in Brazil. Methods:conducted a narrative review based on the search for articles on Scielo, Bireme, Jstor platforms and at the World Health Organization and the Brazilian Ministry of Health webpages, with the keywords big data, bioethics and ethics, from May to July 2020. Results: limits were evidenced in the useof big data as an epidemiological forecasting surveillance tool, notably with its use during the Covid-19 pandemic, although justified by the Bioethics of Protection Theory and Public Health Ethics. The greatest limits observed were the absence of adequate data protection legislation and bias in the data obtained. Conclusion:in order to analyze the bioethical impacts of the use of big data in the medicine of the future, it is essential to deepen the discussion on the possible impacts that the use of thesetechnologies can have on life in society, with an emphasis on the development of surveillance capitalism, on interference in life and the intensification of regional inequalities.

Objetivo: discutir las implicaciones bioéticas del anuncio de la Salud Digital por laOrganización Mundial de la Salud y el uso de macrodatos en la producción de sistemas devigilancia predictiva de salud en Brasil. Metodología:se realizó una revisión narrativa a partirde la búsqueda de artículos en las plataformas Scielo, Bireme, Jstor y en la página de laOrganización Mundial de la Salud y el Ministerio de Salud de Brasil, con las palabras clavemacrodatos, bioética y ética, de mayo a julio, 2020. Resultados:se evidenciaron límites enel uso de macrodatos como herramienta de vigilancia epidemiológica predictiva, destacandosu uso durante la pandemia Covid-19, aunque justificado a partir de la teoría de la Bioéticade Protección y la Ética en Salud Pública. Los mayores límites observados fueron laausencia de una legislación de protección de datos adecuada y el sesgo en los datosobtenidos. Conclusión:para analizar los impactos bioéticos del uso de macrodatos en lamedicina del futuro, es fundamental profundizar la discusión sobre los posibles impactos queel uso de estas tecnologías puede tener en la vida en sociedad, con énfasis en el desarrollodel capitalismo de vigilancia, en la interferencia en la vida y la intensificación de lasdesigualdades regionales.

Análise descritiva do comportamento de adultos na participação de atividade física na cidade de Salvador, Bahia, Brasil / Descriptive analysis of behavior of adults in the participation of physical activity in Salvador, state of Bahia, Brazil / Análisis descriptivo de comportamiento de adultos en la participación en actividad física en la ciudad de Salvador, Bahia, Brasil

O objetivo deste estudo é fornecer informações sociodemográficas e de características individuais de adultos, relacionados à participação de atividade física (AF) da população residente na cidade de Salvador, Bahia, na expectativa de gerar informações que auxiliem a elaboração de políticas públicas direcionadas à promoção da saúde da população soteropolitana. Foram analisados dados de 2.030 adultos (≥ 18 anos de idade) de ambos os sexos, participantes do sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) de 2018. Os homens estavam fisicamente mais ativos do que as mulheres no lazer e no trabalho, enquanto as mulheres estavam mais ativas nas atividades domiciliares. Ser solteiro e/ou divorciado e ter maior escolaridade parece favorecer a participação em AF. Entre os cinco tipos AF recreativa mais praticados, a caminhada foi a atividade mais prevalente em ambos os sexos, com 24,7% e 21,3% da população feminina e masculina, respectivamente, seguida de musculação (7,2%), ginástica geral (5,0%), futebol/futsal (4,0%) e corrida (3,0%). A participação de musculação, futebol/futsal e corrida foi mais frequente na parcela masculina da população, enquanto a participação de ginástica geral foi alavancada pela atuação feminina. A persistência dos estereótipos de gênero pode explicar, em partes, a diversidade e a prevalência em certas modalidades de AF entre homens e mulheres. A continuidade e a periodicidade do monitoramento da AF pelo Vigitel permitirão o acompanhamento das tendências comportamentais da população de Salvador em relação à participação de AF, enquanto estudos futuros, com metodologias apropriadas, poderão explicar as diferenças dos padrões de AF entre os sexos.

This study seeks to provide demographic and personal behavior information about the participation in physical activity (PA) in the municipality of Salvador, state of Bahia, Brazil population, hoping to expand directed support to that population's health using PA promotion. Data from 2,030 adults (≥ 18 years old) of both sexes that participate in the Risk and Protection Factors for Chronic Disease Surveillance System by Telephone Survey (Vigitel) in the year 2018 were analyzed, including sociodemographic and individual behavior variables related to participation in PA. Men were more physically active than women at leisure and at work, and women were more active than men at home (house cleaning). Being single and/or divorced and having a high level of education seems to favor the practice of PA. Among the five most practiced PA modalities, walking was preferred by 23.5% of the population, followed by weight training (7.2%), general gymnastics (5.0%), soccer/futsal (4.0%) and running (3.0%). Walking was the most practiced by both sexes, with a prevalence of 24.7% and 21.3% in the female and male population, respectively. The practice of weight training, soccer/futsal and running was more frequent in the male segment, whereas general gymnastics was leveraged by female participation. The persistence of gender stereotypes could explain, in part, the diversity and prevalence in certain modalities between men and women. The continuity and periodicity of PA monitoring by Vigitel will allow the monitoring of the behavioral trends of the population of Salvador regarding the participation in PA, and future studies with appropriate methodologies may explain the differences in PA patterns between genders.

El objetivo de este estudio es brindar información sociodemográfica y características individuales de los adultos, relacionadas con la participación en actividad física (AF) de la población residente en la ciudad de Salvador (Bahia, Brasil), para generar datos que servirán en la elaboración de políticas públicas orientadas a promover la salud de la población de Salvador. Se analizaron datos de 2.030 adultos (≥ 18 años de edad) de ambos sexos, participantes del Sistema de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas por Encuesta Telefónica (Vigitel) de 2018. Los varones eran físicamente más activos que las mujeres en el tiempo libre y en el trabajo, mientras que las mujeres eran más activas en las actividades del hogar. Ser soltero y/o divorciado y tener estudios superiores parece favorecer la participación en AF. Entre los cinco tipos de AF recreativa más practicada, caminar fue la más prevalente para ambos sexos, con un 24,7% y un 21,3% en la población femenina y masculina, respectivamente, seguido del entrenamiento con pesas (7,2%), gimnasia general (5,0%), fútbol/futsal (4,0%) y carreras (3,0%). El entrenamiento con pesas, el fútbol/futsal y la carrera fueron las más frecuentes entre los varones, mientras que la gimnasia general fue más practicada por las mujeres. La persistencia de estereotipos de género podría explicar, en parte, la diversidad y prevalencia de ciertos tipos de AF entre varones y mujeres. La continuidad y la periodicidad del seguimiento de AF por Vigitel permitirán monitorear las tendencias de comportamiento de la población de Salvador en relación a la participación en AF, y estudios futuros con metodologías adecuadas pueden explicar las diferencias en los patrones de AF entre géneros.

Perfil dos casos de violência interpessoal e/ou autoprovocada atendidos em um hospital público do Paraná, 2014 a 2018 / Profile of cases of interpersonal violence and/or self-harm treated at a public hospital in Paraná, 2014 to 2018 / Perfil de casos de violencia interpersonal y/o autoinfligida atendidos en un hospital público en Paraná, 2014 a 2018

Justificativa e objetivos: descrever o perfil epidemiológico das violências interpessoais e/ou autoprovocadas atendidas em um hospital público do Paraná entre 2014 e 2018. Métodos: estudo descritivo de fonte de dados secundários, coletados a partir do banco de dados do Sistema de Informação de Agravos de Notificação (SINAN) e notificados pelo Núcleo de Vigilância Epidemiológico Hospitalar (NVEH). Resultados: foram notificados 1645 casos de violência. Destes, 1488 (90,4%) casos foram considerados interpessoais e 157 (9,6%) autoprovocados. A faixa etária predominante foi de 1 a 4 anos (26,6%) e a cor/raça branca (83,2%) predominou. O tipo de violência predominante foi negligência/abandono e prevaleceram violências ocorridas na residência. O grau de parentesco com a vítima predominante foi pai e mãe. Conclusão: O tipo de violência predominante foi negligência/abandono. Quanto às características da vítima, não houve diferença entre masculino e feminino, incluiu indivíduos predominantemente brancos, escolaridade não informada, idades entre 1 e 4 anos e residentes na área urbana. Quanto ao autor da violência, prevaleceram os casos em que a mãe foi notificada como autora, e o meio da agressão foram os casos caracterizados como outro tipo de agressão.(AU)

Justification and Objective: describe the epidemiological profile of interpersonal violence and/or self-harm treated at a public hospital in Paraná between 2014 and 2018. Methods: descriptive study of secondary data sources collected from the database of the Information System on Diseases of Compulsory Declaration (Portuguese acronym: SINAN) notified by the Hospital Center of Epidemiological Surveillance (Portuguese acronym: NVEH). Results: the total of 1645 cases of violence were reported, out of which 1488 (90.4%) cases of interpersonal violence and 157 (9.6%) of self-harm. The age group of 1 to 4 years (26.6%), and white color (83.2%) predominated. The predominant type of violence was neglect/abandonment and violence occurring at home prevailed. The predominant degree of kinship with the victim was father and mother. Conclusion: the predominant type of violence was neglect/abandonment. The victims' characteristics showed no difference between male and female, predominance of white individuals, uninformed schooling, age between 1 and 4 years old, residents in the urban area. As for the perpetrator of violence, cases in which the mother was notified as the author prevailed, and the means of aggression were cases characterized as 'other type of aggression'.(AU)

Justificación y objetivos: describir el perfil epidemiológico de la violencia interpersonal y/o autoinfligida en un hospital público de Paraná entre 2014 y 2018. Métodos: un estudio descriptivo de fuentes de datos secundarias, recopilado de la base de datos del Sistema de Información de Enfermedades de Declaración Obligatoria (Acrónimo en portugués: SINAN) notificado por el Centro de Vigilancia Epidemiológica del Hospital (Acrónimo en portugués: NVEH). Resultados: se reportaron 1645 casos de violencia, de los cuales 1488 (90,4) interpersonales y 157 (9,6%) autoinfligidos. El grupo de edad predominante fue de 1 a 4 años (26,6%), y predominó el color blanco de la piel (83,2%). El tipo de violencia que predominó fue abandono/negligencia y prevaleció la violencia ocurrida en el hogar. El grado de parentesco con la víctima predominante fue padre y madre. Conclusión: el tipo predominante de violencia fue abandono/negligencia. En cuanto a las características de la víctima, no hubo diferencia entre hombres y mujeres, ya que se componía de individuos predominantemente blancos, con escolarización no informada, entre las edades de 1 a 4 años, que vivían en el área urbana. En cuanto al autor de la violencia, prevalecieron los casos en que se notificó a la madre como autor, y los casos se caracterizaron como otro tipo de agresión como medio de agresión.(AU)

Problematização sobre a pandemia da COVID-19 como auxílio na formação de enfermeiras/os / Problematization about COVID-19 pandemic as aid in the formation of nurses / Problematización de la pandemia COVID-19 como ayuda en la formación de enfermeras

Introdução: Vivenciamos, com a Pandemia COVID-19, especulações em vários campos, com agravamentos na saúde dos indivíduos e condições econômicas dos países, principalmente daqueles vulneráveis e marginalizados nas sociedades neoliberais contemporâneas. Frente a situação, estratégias foram desenvolvidas para inserir o conteúdo COVID-19 nas disciplinas que compõe a matriz do Curso de Enfermagem do Centro Universitário São Camilo. Método: A disciplina de Vigilância em Saúde utilizou-se da abordagem por problemas. Resultado: Na realização de pesquisas, discussões em grupos e finalização das atividades propostas foram versados assuntos diversificados de interesse na formação dos estudantes para prepará-los para as atividades inerentes da Vigilância em Saúde, bem como, integrar outros temas. Conclusão: A escolha da abordagem educacional e estratégias escolhidas na Vigilância em Saúde são importantes para que nossos futuros enfermeiros possam lidar com mais precisão com as situações emergentes e reemergentes que estão e estarão pairando entre todos os locais de vivência humana.(AU)

Introduction: With Pandemic COVID-19, we have experienced speculation in various fields, with deterioration in the health of individuals and economic conditions in the countries, especially those vulnerable and marginalized in contemporary neoliberal societies. Faced with the situation, strategies were developed to insert the COVID-19 content in the disciplines that make up the matrix of the Nursing Course at Centro Universitário São Camilo. Method: The discipline of Health Surveillance used the problem approach. Result: In conducting research, group discussions and finalizing the proposed activities, diversified subjects of interest in the training of students were hijacked to prepare them for the inherent activities of Health Surveillance, as well as to integrate other themes. Conclusion: The choice of the educational approach and strategies chosen in Health Surveillance are important so that our future nurses can deal more accurately with the emerging and reemerging situations that are and will be hovering between all places of human experience.

Introducción: Con la pandemia COVID-19, estamos experimentando especulaciones en varios campos, con el empeoramiento de la salud de las personas y las condiciones económicas en los países, especialmente aquellos vulnerables y marginados en las sociedades neoliberales contemporáneas. En vista de la situación, se desarrollaron estrategias para insertar el contenido de COVID-19 en las disciplinas que conforman la matriz del Curso de Enfermería en el Centro Universitario São Camilo. Método: La disciplina de vigilancia de la salud utilizó el enfoque del problema. Resultado: al realizar investigaciones, discusiones grupales y finalizar las actividades propuestas, se diversificaron temas diversificados de interés en la capacitación de los estudiantes para prepararlos para las actividades inherentes de la Vigilancia de la Salud, así como para integrar otros temas. Conclusión: La elección del enfoque educativo y las estrategias elegidas en la Vigilancia de la salud son importantes para que nuestras futuras enfermeras puedan lidiar con mayor precisión con las situaciones emergentes y reemergentes que se ciernen y se ciernen entre todos los lugares de la experiencia humana.(AU)

[Ebola alert: results and challenges in public health. A view from Catalonia (Spain)]. / Resultados y retos en salud pública ante la alerta por Ébola: una perspectiva desde Cataluña.

The Ebola outbreak in Guinea Conakry was notified to the World Health Organization (WHO) in March 2014. It is the most complex Ebola outbreak to date, affecting Guinea Conakry as well as the surrounding countries and with a risk of the disease spreading outside Africa. For this reason, the World Health Organization declared this Ebola outbreak an international public health emergency in August 2014. The Public Health Agency of Catalonia, through the Spanish Alert and Emergencies Coordination Network, initiated public health actions in March 2014, developing a single protocol of action to be applied by all the health care providers in the whole Catalan territory, advice for travellers and voluntary workers arriving from affected countries and a weekly newsletter addressed to health professionals. At the same time, the Ebola Analysis and Monitoring Committee and the Ebola Scientific and Advisory Committee were established. More than 9600 professional health workers attended training sessions and informative sessions. From August 2014, the Catalan Epidemiological Surveillance Emergency Service (SUVEC) reported 117 suspected Ebola cases, of which only 3 met the epidemiological and clinical criteria leading to the activation of the action protocol. All 3 cases proved negative for Ebola. Also, 95 voluntary workers were monitored, 52% of whom were female and 74% had returned from Sierra Leone. Dealing with the suspected Ebola cases required a detailed advance preparation and planning, with a coordinated effort between the epidemiological and health-care network, and all the agents involved, as well as precise, realistic and appropriate risk communication. The prior screening of suspected Ebola cases by the SUVEC meant the immediate protocol was activated only in the cases that met the epidemiological and clinical criteria. This is a key point to be reinforced in any future international public health alerts.

Propuesta de un programa de vigilancia ambiental y de salud para trabajadores con exposición a agentes químicos en fundiciones de cobre en Chile / Environmental and health surveillance program proposal for workers exposed to chemical agents in copper smelters in Chile

RESUMEN El presente trabajo tiene por objetivo proponer un programa de vigilancia ambiental y de salud para trabajadores expuestos a agentes químicos en fundiciones de cobre. La metodología fue en base a revisión bibliográfica en inglés y en español, búsqueda manual dirigida y criterio de expertos por medio de entrevistas cualitativas no estructuradas. El proceso de búsqueda se dividió en dos etapas, la primera orientada a responder dos preguntas relacionadas al estado del arte de programas preventivos de exposición y, la segunda, relacionada a búsqueda de referencias orientada a la vigilancia ambiental y de la salud en el trabajo. Se seleccionaron artículos científicos, donde se identificaron protocolos, normas, estándares y documentos de diversas organizaciones para la vigilancia ambiental y de la salud, desde los cuales se realizó una nueva búsqueda manual dirigida, sustentada por la directrices señaladas por expertos de las áreas de Higiene y Salud Ocupacional que colaboraron en el diseño del programa. Como resulado, los puntos más importantes fueron la identificación, evaluación y control de los agentes en contacto con los trabajadores como As, Hg, Pb, SO2, SiO2, Cd, Cr, Zn y Cu; propuesta de los niveles de riesgo y exposición en base a la presencia y el contacto de los contaminantes; se determinaron los niveles de acción para la vigilan cia ambiental y de la salud en niveles de 1 a 5; y finalmente los exámenes médicos y su periodicidad.

ABSTRACT This work aims to propose an environmental and health surveillance program for workers exposed to chemical agents in copper foundry. The methodology was based on a bibliographical review in English and Spanish, directed manual search and expert judgment through unstructured qualitative interviews. The search process was divided into two stages; the first one aimed answering two questions related to the state of the art of preventive exposure programs, and the second, related to reference search aimed at environmental monitoring and health at work. Scientific articles were selected, where protocols, norms, standards and documents from various organizations for environmental and health surveillance were identified, from which a new manual search was conducted, supported by the guidelines indicated by experts from the areas of Hygiene And Occupational Health that collaborated in the design of the program. As a result, the most important points were the identification, evaluation and control of agents in contact with workers such as As, Hg, Pb, SO2, SiO2, Cd, Cr, Zn and Cu; Proposal of risk and exposure levels based on the presence and contact of pollutants; the levels of action for environmental and health surveillance were determined at levels 1 to 5; And finally the medical examinations and their periodicity.

[Seroprevalence of varicella-zoster virus antibodies after the recent introduction of the universal childhood immunisation schedule in the Community of Madrid]. / Seroprevalencia de anticuerpos frente al virus de la varicela zóster tras la introducción reciente de la vacunación infantil universal en la Comunidad de Madrid.

BACKGROUND AND OBJECTIVE: In November 2006, the Community of Madrid included the chickenpox vaccine into the immunisation schedule for children from 15 months of age. This was withdrawn in January 2014. Seroprevalence of antibodies to the virus is estimated after the first 2-3 years from the inclusion of the vaccine, and as well as its evolution since 1999. MATERIAL AND METHOD: A cross-sectional study was conducted on the target population consisting of residents in the Community of Madrid between 2 and 60 years of age. Measurement of IgG antibodies was performed using an ELISA technique. Seroprevalence was estimated according to sociodemographic characteristics using multiple logistic regressions. The results are compared with previous surveys. Also, the seroprevalence and geometric mean of the antibody according immunisation status and history of the disease are presented. The confidence level used is 95%. RESULTS: A total of 4,378 subjects were included, with a response rate of 69%. The estimated seroprevalence was 95.3% (95% CI: 94.6% - 95.9%). Over 90% of children from the age of 10 have antibodies. The seroprevalence was higher in people with less education. The seroprevalence of immunity vaccine exceeds 90% in the first year after vaccination, but in the second year decreased to 82.6% (95% CI 56.0 - 94.7). Significant differences, attributable to universal vaccination, were found compared to previous surveys. DISCUSSION: Continued surveillance is needed in order to assess the impact of the withdrawal of the recommendation to vaccinate at 15 months.

[Hospital detention in tuberculosis control]. / La hospitalización terapéutica obligatoria en el control de la tuberculosis.

This article describes the actions of public health services of the city of Barcelona to prevent tuberculosis transmission by noncompliant smear-positive patients by using the possibilities of Spanish Law 3/1986. The actions were based on a resolution of the health authorities on the need to locate such patients and to detain them in hospitals to provide treatment. This involved police cooperation, informing noncompliant patients, and requesting ratification from the Administrative Court. The article describes the process and the characteristics of the cases involved. Over nine years, from July 2006 to June 2015, the law was used in only twelve cases. The authors conclude that the criteria of prudence and proportionality were used in the application of the law, which resulted in the treatment of patients who posed a risk to their environment, reducing the transmission of infection.

Pesquisa de factores de riesgo en niños preescolares de diferentes municipios de Cuba, 2006-2007 / Risk factor screening of preschool children from several municipalities in Cuba, 2006-2007

El desarrollo y la salud infantil están bajo la influencia e interacción de múltiples factores de riesgo, cuya identificación y control constituyen una contribución evitable de alteraciones de la salud y del aprendizaje escolar. Este enfoque permite conocer la necesidad de atención que tienen grupos específicos de la población para organizar los servicios y establecer acciones para la prevención. El universo de estudio estuvo constituido por 4 200 niños preescolares asistentes a círculos infantiles y a escuelas primarias de nueve municipios del país. Además, fue realizada la evaluación de la madurez escolar a una submuestra de 447 preescolares y 1 970 escolares de primer grado de la enseñanza primaria. Fueron utilizados metodologías e instrumentos validados que estandarizaron la información relacionada con el cuadro de salud, los que aportaron evidencias científicas sobre la base de los factores de riesgo identificados, sobre todo a nivel sociofamiliar, para el perfeccionamiento de la vigilancia en salud y el diseño de nuevas estrategias de prevención y promoción de salud en el ámbito escolar y comunitario. El estudio realizado se fundamentó en la necesidad de identificar los factores de riesgo desde edades tempranas de la vida, lo cual posibilita la reorientación de estrategias preventivo-educativas mediante el trabajo integrado de docentes, padres y salubristas

The development and child health under the influence and interaction of multiple risk factors, the identification and control are a contribution of preventable health disorders and school learning. This approach allows to know the need of care are specific population groups to organize services and establish actions for prevention. The study group consisted of 4 200 preschool children attending day care centers and elementary schools in nine municipalities. He was also on the school readiness assessment of a subsample of 447 preschoolers and 1 970 first-grade primary school. Methodologies and tools used were validated standardized information related to the picture of health, providing scientific evidence on the basis of identified risk factors especially at family member, for the improvement of health surveillance and the design of new strategies prevention and health promotion in schools and community. This study was based in the necessity to identify the factors of risk from early ages of the life, which permits to guide the preventive-educational strategies with the integrated work of educators, parents and health workers

Pesquisa de factores de riesgo en niños preescolares de diferentes municipios de Cuba, 2006-2007 / Risk factor screening of preschool children from several municipalities in Cuba, 2006-2007

El desarrollo y la salud infantil están bajo la influencia e interacción de múltiples factores de riesgo, cuya identificación y control constituyen una contribución evitable de alteraciones de la salud y del aprendizaje escolar. Este enfoque permite conocer la necesidad de atención que tienen grupos específicos de la población para organizar los servicios y establecer acciones para la prevención. El universo de estudio estuvo constituido por 4 200 niños preescolares asistentes a círculos infantiles y a escuelas primarias de nueve municipios del país. Además, fue realizada la evaluación de la madurez escolar a una submuestra de 447 preescolares y 1 970 escolares de primer grado de la enseñanza primaria. Fueron utilizados metodologías e instrumentos validados que estandarizaron la información relacionada con el cuadro de salud, los que aportaron evidencias científicas sobre la base de los factores de riesgo identificados, sobre todo a nivel sociofamiliar, para el perfeccionamiento de la vigilancia en salud y el diseño de nuevas estrategias de prevención y promoción de salud en el ámbito escolar y comunitario. El estudio realizado se fundamentó en la necesidad de identificar los factores de riesgo desde edades tempranas de la vida, lo cual posibilita la reorientación de estrategias preventivo-educativas mediante el trabajo integrado de docentes, padres y salubristas(AU)

The development and child health under the influence and interaction of multiple risk factors, the identification and control are a contribution of preventable health disorders and school learning. This approach allows to know the need of care are specific population groups to organize services and establish actions for prevention. The study group consisted of 4 200 preschool children attending day care centers and elementary schools in nine municipalities. He was also on the school readiness assessment of a subsample of 447 preschoolers and 1 970 first-grade primary school. Methodologies and tools used were validated standardized information related to the picture of health, providing scientific evidence on the basis of identified risk factors especially at family member, for the improvement of health surveillance and the design of new strategies prevention and health promotion in schools and community. This study was based in the necessity to identify the factors of risk from early ages of the life, which permits to guide the preventive-educational strategies with the integrated work of educators, parents and health workers(AU)