Prevención de infecciones asociadas a cuidados de la salud en pacientes quemados / Prevention of healthcare-associated Infections in burn patients

Las infecciones asociadas a cuidados de la salud (IACS) son una de las complicaciones más importantes que presentan los pacientes gran quemados. Aumentan su morbimortalidad, la duración de su estadía, el consumo de antimicrobianos y los costos hospitalarios. Las tasas reportadas de IACS son muy variables entre los distintos países y centros de atención.El ánimo de esta publicación es brindar el material necesa-rio y actualizado de las medidas de control de infecciones que se deben implementar en la atención de los quemados ya que no es fácil disponer de información sobre este tema.En la presente revisión se analizaron estudios de distin-tas poblaciones, adultos y niños, con diferentes tipos que-maduras y diversos lugares de atención. Se utilizó como material de referencia las recomendaciones vigentes de la Sociedad Internacional de injurias por Quemaduras (ISBI, por su sigla inglés) y se adicionaron publicaciones y expe-riencias de grupos de trabajo local e internacional referen-tes en el tema.Se describen cinco tipos de medidas de control y preven-ción de IACS: medidas generales, medidas de higiene am-biental, prevención de la infección de los lechos de las que-maduras, profilaxis antibiótica y medidas de prevención de neumonía, infecciones asociadas a catéteres vasculares y vesicales en quemados. Es esencial implementar un enfoque proactivo y multidisci-plinario del control de infecciones en la atención de estos pacientes, generando recomendaciones adaptadas a la realidad de cada centro de salud, destinadas a disminuir las transmisión cruzada de microorganismos, utilizar los antimicrobianos tópicos y sistémicos en forma adecuada, disminuir la multirresistencia, reducir las IACS y su mor-talidad

Healthcare-associated infections (HAIs) are one of the most important complications of severe burn patients. They increase their morbidity and mortality, length of stay, antimicrobial consumption, and hospital costs. Re-ported rates of IACS vary widely across countries and care settings.The purpose of this publication is to provide the nec-essary and up-to-date material on the infection control measures that should be implemented in the care of burn patients, since it is not easy to have information on this subject.In this review, we analysed studies of different popula-tions, adults and children, with different types of burns and different places of care. The current recommenda-tions of the International Society of Burn Injuries (ISBI) were used as reference material, and publications and experiences of local and international working groups on the subject were added. Five types of IACS control and prevention measures are described: General mea-sures, Environmental hygiene measures, Prevention of infection of burn injuries, Antibiotic prophylaxis and pre-vention measures for pneumonia, infections associated with vascular and bladder catheters in burn patients.Conclusion: It is essential to implement a proactive and multidisciplinary approach to infection control in the care of these patients, generating recommendations adapted to the reality of each health center, aimed at reducing cross-transmission of microorganisms, using typical and systemic antimicrobials appropriately, reduc-ing multiresistance, reducing HAIs and their mortality

Saúde e saneamento: uma avaliação das políticas públicas de prevenção, controle e contingência das arboviroses no Brasil / Health and sanitation: an evaluation of public policies for the prevention, control, and contingency of arboviruses in Brazil

Resumo As arboviroses, sobretudo as transmitidas pelo mosquito Aedes aegypti, têm-se constituído em grave problema de saúde pública no Brasil. Com o intuito de analisar como o saneamento básico é abordado em instrumentos norteadores das políticas públicas de controle das arboviroses no país, foi realizada uma análise de conteúdo em oito documentos governamentais de referência. Como resultados, foi possível identificar que aspectos relacionados à comunicação e mobilização social, controle vetorial e gestão são os temas mais abordados nos documentos analisados. Já as componentes do saneamento básico, destacando-se o manejo e a drenagem das águas pluviais e o esgotamento sanitário não são abordados nos instrumentos. A intersetorialidade é mencionada, no entanto, não existem proposições específicas que apontem e assegurem sua implementação. As Diretrizes Nacionais para a Prevenção e Controle de Epidemias de Dengue, do Ministério da Saúde, constitui-se no documento mais completo sobre o assunto. Conclui-se que o saneamento básico não está suficientemente abordado nos instrumentos de enfrentamento às arboviroses o que pode contribuir para a baixa efetividade de intervenção pública e que, portanto, tal contradição precisa ser superada pelas políticas públicas no Brasil.

Abstract Arboviruses, especially those transmitted by the Aedes aegypti mosquito, have become a serious public health problem in Brazil. In order to analyze how sanitation is addressed in the basic guidelines of public policies to control arboviruses in the country, content analysis was performed on eight governmental reference documents. As a result, it was possible to identify that aspects related to communication and social mobilization, vector control, and management are the themes most addressed in the documents analyzed. On the other hand, the components of basic sanitation, especially rainwater management and drainage, and sewage control, are not addressed in the instruments. Intersectorality is mentioned, however, there are no specific proposals to implement the plan and ensure its implementation. The Ministry of Health's National Guidelines for the Prevention and Control of Dengue Epidemics is the most complete document on the subject. The conclusion drawn is that basic sanitation is not sufficiently addressed in the instruments for combatting arboviruses, which can contribute to the low effectiveness of public intervention and, consequently, this discrepancy needs to be focused on by public policies in Brazil.

Dynamic Self-Determination of Self-Care and Positive Deviance Model for Stunting Prevention in Indonesia

ABSTRACT Objective: To describe the dynamic self-determination of self-care (DSDoSC) and positive deviance (PD) models in changing stunting prevention behavior. Material and Methods: This research is a quasi-experimental study with a sample of 90 mothers taken by purposive sampling. Thirty mothers were given the DSDoSC intervention, 30 were given the PD intervention, and another 30 were in the control group. This research was conducted in July - October 2019. The variables studied were feeding behavior, nurturing behavior, personal hygiene behavior, environmental cleanliness and air sanitation, and behavior seeking health services. To analyze the difference in mother behaviour before and after test, we used Paired t-test. Analysis of Variance (MANOVA) was used to analyze the difference of mother behaviour among groups. The level of significance was p<0.05. Results: The PWD group showed that eating behavior, parenting behavior, personal hygiene behavior, environmental hygiene and water sanitation, and behavior seeking health services had significant numbers. In the DSDoSC group, eating behavior, parenting behavior, environmental hygiene, water sanitation and health service-seeking behavior were significantly (p<0.05). The results of the Manova test showed that there was an effect of PD and DSDoSC on stunting prevention behavior. Conclusion: Self-dynamic for self-care model and the positive deviance model both can change a mother's behavior for the better in feeding, parenting, environmental hygiene, and water sanitation, seeking health services, but not changing behavior about personal hygiene behavior.

Hospital sustainability indicators and reduction of socio-environmental impacts: a scoping review / Indicadores de sostenibilidad hospitalaria y reducción de impactos socioambientales: una scoping review / Indicadores de sustentabilidade hospitalar e redução de impactos socioambientais: uma revisão de escopo

ABSTRACT Objective: To synthesize knowledge about hospital sustainability indicators and evidence of reduced socio-environmental impact. Method: Literature scoping review using Pubmed, Science Direct, Scielo and Lilacs databases. Studies in a time frame of 10 years, addressing hospital sustainability indicators and evidence of reduced socio-environmental impact published in any language were included. Results: A total of 28 articles were included, most were applied research, published in 2012, in English. Studies showed ways to save water and energy, as well as ways to monitor and mitigate the impact of activities related to effluents, waste and emissions. All studies had nursing work directly or indirectly involved in hospital sustainability. Conclusion: The possibilities of generating less impact on the environment and increasing the economy/efficiency of a hospital are countless. The particularities of each hospital must be taken into account and workers, especially nurses, should be involved.

RESUMEN Objetivo: Sintetizar conocimientos sobre indicadores de sostenibilidad hospitalaria y evidencias de reducción del impacto socioambiental. Método: Revisión de literatura, scoping review, utilizando las bases de datos Pubmed, Science Direct, Scielo y Lilacs. Se incluyeron estudios con un horizonte temporal de 10 años, publicados en cualquier idioma, que abordaran indicadores de sostenibilidad hospitalaria y evidencias de reducción del impacto socioambiental. Resultados: Se incluyeron un total de 28 artículos, la mayoría de investigación aplicada, publicados en 2012, en inglés. Los estudios mostraron formas de ahorrar agua y energía, así como formas de monitorear y mitigar el impacto de las actividades relacionadas con efluentes, desechos y emisiones. Todos los estudios tenían trabajo de enfermería involucrado directa o indirectamente en la sostenibilidad del hospital. Conclusión: Las posibilidades de generar un menor impacto en el medio ambiente y aumentar la economía/eficiencia de un hospital son innumerables. Hay que tener en cuenta las particularidades de cada hospital y se debe involucrar a los trabajadores, especialmente a los enfermeros.

RESUMO Objetivo: Sintetizar o conhecimento acerca dos indicadores de sustentabilidade hospitalar e evidências de redução do impacto socioambiental. Método: Revisão de literatura, do tipo scoping review, utilizando as bases de dados Pubmed, Science Direct, Scielo e Lilacs. Foram incluídos estudos com recorte temporal de 10 anos, publicados em qualquer idioma, que abordassem indicadores de sustentabilidade hospitalar e evidências de redução do impacto socioambiental. Resultados: Um total de 28 artigos foram incluídos, a maioria teve como tipo de estudo a pesquisa aplicada, publicados em 2012, no idioma inglês. Os estudos demonstraram maneiras de economizar água e energia, bem como, formas de monitorar e mitigar o impacto de atividades relacionadas a efluentes, resíduos e emissões. Todos os estudos tinham o trabalho da enfermagem envolvido de forma direta ou indireta na sustentabilidade hospitalar. Conclusão: As possibilidades de gerar menos impacto ao meio ambiente e aumentar a economia/eficiência de um hospital são inúmeras. Há de se levar em consideração as particularidades de cada hospital e envolver os trabalhadores, em especial a enfermagem.

Sanear é eugenizar: a eugenia "preventiva" de Belisário Penna a serviço do saneamento do Brasil, 1920-1930 / To sanitize is to eugenize: the "preventive" eugenics of Belisário Penna at the service of sanitation in Brazil, 1920-1930

Resumo Discute o modelo de eugenia empregado pelo médico-sanitarista Belisário Penna durante a campanha do saneamento do Brasil nas décadas de 1920 e 1930. São abordados dois conceitos fundamentais para o seu pensamento: "raça brasileira" e eugenia "preventiva". A maneira como Penna avaliava a questão racial brasileira era fundamental para aderir à concepção eugênica aliada à medicina social e ao seu projeto de "consciência sanitária". O texto oferece uma perspectiva de como foi bordada a concepção eugênica de Penna e o diálogo estabelecido com o movimento eugênico brasileiro, em especial com o eugenista Renato Kehl. Assim, a defesa de uma eugenia classificada como "preventiva" estabelecia coerência para um projeto reformista social via o saneamento defendido por Penna.

Abstract The purpose of this article is to discuss the eugenics model used by the medical-sanitarist Belisário Penna during the sanitation campaign in Brazil in the 1920s and 1930s. The article addresses two fundamental concepts for his thinking: "Brazilian race" and "preventive" eugenics. The way in which Penna saw the Brazilian racial issue was fundamental to adhere to the eugenic conception combined with social medicine and its project of "health awareness." The text offers a perspective of how Penna's eugenics was conceived and the dialogue established with the Brazilian eugenic movement, especially with the eugenicist Renato Kehl. Thus, the defense of an eugenics classified as "preventive" established a coherence for a social reform project through the sanitation defended by Penna.

Intervenciones en mitigación y contención contra la COVID-19 implementadas en pueblos indígenas de Perú, Brasil, Colombia y Ecuador / Interventions in mitigation and containment against COVID-19 implemented in indigenous peoples of Peru, Brazil, Colombia and Ecuador

La publicación evidencia la necesidad de generar espacios que brinden la oportunidad de revisar y analizar las experiencias y percepciones que los diferentes actores sociales tienen sobre las acciones implementadas, facilitando la mejora de prácticas e intervenciones sanitarias dirigidas a los pueblos indígenas u originarios

Monitoreo de la vigilancia, prevención y control de las enfermedades transmitidas por el Aedes aegypti / Surveillance monitoring, prevention and control of diseases transmitted by Aedes Aegypti

La actual propuesta metodológica se enmarca en los dos primeros objetivos del Plan Nacional de la Lucha contra el Dengue, que son promover, coordinar y facilitar la implementación de estrategias eficaces y oportunas para el control y tratamiento del dengue, con especial énfasis en las zonas geográficas del país que presentan alto riesgo potencial epidémico de dicha enfermedad, y gestionar la cooperación técnica destinada al control y manejo del dengue. En la fase inicial, se determinaron las actividades y variables sensibles a monitoreo, en base a los objetivos e indicadores identificados dentro del marco técnico y normativo vigente en el Perú y el marco sanitario establecido por la OMS, correspondientes a la vigilancia, prevención y control, pero, además, a la promoción de prácticas saludables. Luego, se definieron los requerimientos no funcionales de la plataforma de monitoreo para el desarrollo de un aplicativo accesible a través de un navegador en cualquier dispositivo con acceso a internet, a ser alojado en la plataforma de Cloud Computing. Posteriomente, se realizó el flujograma para el monitoreo de la clasificación de escenarios epidemiológicos y estratificación de riesgo entomológico de las enfermedades transmitidas por el Aedes aegypti. Finalmente, tanto la estratificación de riesgo como los indicadores obtenidos en cada localidad son escalados a la unidad notificante, encarcada de la ratificación, análisis y toma de desiciones jurisdiccionales. Se realizó una prueba piloto en 50 distritos de la jurisdicción de Lima Metropolitana. Se encontró que once distritos fueron estratificados en escenario II, y cuatro distritos en escenario III(AU)

The current methodological proposal is part of the first two objectives of the National Plan to Fight Dengue, which are to promote, coordinate and facilitate the implementation of effective and timely strategies for the control and treatment of dengue, with special emphasis on geographical areas. of the country that present a high potential epidemic risk of this disease and manage technical cooperation for the control and management of dengue. In the initial phase, the activities and variables sensitive to monitoring were determined, based on the objectives and indicators identified within the technical and regulatory framework in force in Peru and the health framework established by the WHO, corresponding to surveillance, prevention, and control; but also, to the promotion of healthy practices. Then, the non-functional requirements of the monitoring platform were defined for the development of an application accessible through a browser on any device with Internet access, to be hosted on the Cloud Computing platform. Subsequently, the flowchart was made to monitor the classification of epidemiological scenarios and entomological risk stratification of diseases transmitted by Aedes aegypti. Finally, both the risk stratification and the indicators obtained in each locality are escalated to the notifying unit, in charge of the ratification, analysis and making of jurisdictional decisions. A pilot test was carried out in 50 districts of the jurisdiction of Metropolitan Lima. It was found that eleven districts were stratified in stage II, and four districts in stage III(AU)

Caderno temático do Programa Saúde na Escola: prevenção do uso do tabaco / Thematic notebook of the School Health Program: prevention of tobacco use

Estudo sobre a prevenção do uso do tabaco

Potencial de reducción de emisiones y captura de carbono en bosques y sistemas agroforestales con cacao en el Pacífico colombiano / Potential for reducing emissions and carbon sequestration in forests and cocoa agroforestry systems in the Colombian Pacific

Resumen Introducción: Los bosques y sistemas agroforestales (SAF) suministran bienes y servicios ecosistémicos para la sociedad, tal como la mitigación del cambio climático. Objetivo: Se estimó el potencial de reducción de emisiones y captura de carbono en bosques y SAF con cacao de la subcuenca del río Munguidó, Colombia. Métodos: Se seleccionaron tres sistemas de uso del suelo (bosque primario, bosque secundario y SAF con cacao). Se establecieron 18 parcelas temporales de muestreo, seis por sistema, para medir los árboles (diámetro a la altura del pecho -dap ≥ 10 cm) y arbustos de cacao. Se cuantificó la biomasa aérea con ecuaciones alométricas y una fracción de carbono de 0.5. Se estimó la fijación de carbono en el bosque secundario y el SAF con cacao como la razón entre el carbono almacenado y su edad. La pérdida de carbono del bosque primario se estimó con base en la deforestación para Chocó y dicha subcuenca (0.6 y 0.3 %/año, respectivamente). Se realizó un análisis de varianza y comparación de medias LSD Fisher para determinar las diferencias en el almacenamiento y la fijación de carbono entre los usos. Resultados: El bosque primario almacenó más carbono que el bosque secundario y el SAF con cacao (190.1, 22.3 y 5.3 Mg/ha, respectivamente). La fijación de carbono del bosque secundario y el SAF con cacao no difirieron (2.23 vs 1.33 Mg/ha/año). En 20 años, el bosque primario presentaría una reducción de emisiones de 1.4-2.6 Tg CO2; y el bosque secundario y el SAF con cacao presentarían una captura de 100.8 y 30.7 Gg CO2, respectivamente. Conclusiones: En la subcuenca del río Munguidó es posible establecer proyectos para la reducción de emisiones en bosque primario y captura de carbono en bosques secundarios y SAF con cacao, con lo cual se podría emitir 1.4-2.6 millones de toneladas de CO2.

Abstract Introduction: Forests and agroforestry systems (AFS) provide ecosystem goods and services for society, such as climate change mitigation. Objective: The potential for emission reductions and carbon sequestration in forests and cocoa agroforestry systems in the Munguidó river sub-basin in Colombia was estimated. Methods: Three land use systems were selected (primary forest, secondary forest and AFS with cocoa). Eighteen temporary sampling plots were established, six per system, to measure trees (diameter at breast height -dbh ≥ 10 cm) and cocoa shrubs. Aboveground biomass was quantified with allometric equations and a carbon fraction of 0.5. Carbon fixation in secondary forest and AFS with cocoa was estimated as the ratio of carbon stored to its age. Carbon loss from primary forest was estimated based on deforestation for Chocó and that sub-basin (0.6 and 0.3 %/year, respectively). An analysis of variance and LSD Fisher mean comparison was performed to determine differences in carbon storage and carbon sequestration between uses. Results: Primary Forest stored more carbon than secondary forest and AFS with cocoa (190.1, 22.3 and 5.3 Mg/ha, respectively). The carbon fixation of secondary forest and AFS with cocoa did not differ (2.23 vs. 1.33 Mg/ha/year). In 20 years, the primary forest would present an emission reduction of 1.4-2.6 Tg CO2; and the secondary forest and the PFS with cocoa would present a sequestration of 100.8 and 30.7 Gg CO2, respectively. Conclusion: In the Munguidó river sub-basin, it is possible to establish projects for the reduction of emissions in primary forest and carbon sequestration in secondary forests and AFS with cocoa, which could emit 1.4-2.6 million tons of CO2.

Bullying y apoyo social percibido en una muestra de escolares chilenos de la región del Maule / Bullying and perceived social support in a sample of Chilean schoolchildren from the Maule region

Resumen Se estudia la relación entre agresión entre pares (incluyendo la agresión cibernética) y el apoyo social percibido en 675 alumnos chilenos, pertenecientes a cursos de sexto año básico a segundo año medio. Se administraron las escalas de agresión entre pares y de apoyo social percibido correspondientes a las variables estudiadas. Los resultados obtenidos, en primer lugar, al evaluar la agresión entre pares muestran diferencias significativas por curso, siendo mayor en niveles educativos más bajos; en segundo lugar, dan cuenta de una relación negativa entre las variables, es decir, cuando los alumnos se insertan en un entorno de agresión entre pares, independiente del rol que ejercen, más bajo es el apoyo social que perciben, coincidiendo con investigaciones previas. Se discute la importancia de incentivar estrategias que refuerce el apoyo social para minimizar los efectos de la agresión entre estudiantes en ambientes educativos e integrar en el aula futuros programas preventivos y de intervención.

Abstract It identifies the relationship between bullying (including cyberbullying) and perceived social support in 675 Chilean students belonging to sixth primary grade to second medium. instruments were applied, the aggression among peers scale and perceived social support The evince that, first in assessing aggression between pairs show significant differences by grade, being higher in lower educational levels and on the other, account for a negative relationship between the variables, ie, when students are inserted into an environment of peer aggression there are lower perceived social support, regardless of the role that they makes, coinciding with previous research. The importance of encouraging strategies that reinforce social support is discussed to minimize the effects of aggression among students in educational settings and to integrate future preventive and intervention programs in the classroom.

Higienización y eliminación fúngica en instalaciones industriales para la disminución de riesgos ocupacionales / Sanitization and fungal elimination in industrial facilities to reduce occupational risks

Se ha comprobado que la exposición a bioaerosoles se asocia con varios efectos sobre la salud, como enfermedades pulmonares y alergias. El presente estudio transversal tuvo como objetivo investigar la contaminación por hongos en varias superficies pertenecientes a dos industrias de alimentos. La toma de muestra se realizó en tres semanas, inmediatamente después de realizada la limpieza y desinfección y antes de iniciar la producción. Se recolectaron 400 muestras de superficie (vidrio, acero inoxidable, aluminio, goma y plástico), también se evaluó la eficacia del programa de higienización en el control de la población de hongos. Todas las muestras presentaron recuentos fúngicos <10 ufc/cm2, sin haber diferencias significativas entre los tipos de superficie, sin embargo, las superficies plásticas exhibieron mayor crecimiento logarítmico de los hongos. Se determinó que 49,60% de las especies identificadas correspondieron al género Penicillium. Aunque los niveles de hongos en las industrias estudiadas fueron inferiores a los niveles recomendados por la Organización Mundial de la Salud, algunas medidas de salud ambiental como lavar y desinfectar las superficies después de cada turno de trabajo, y se recomiendan inspecciones periódicas para garantizar la seguridad de los trabajadores y de los productos que allí se manufacturan(AU)

It has been proven that exposure to bioaerosols is associated with several health effects, such as pulmonary diseases and allergies. The present crosssectional study aimed to investigate fungal contamination on various surfaces belonging to two food industries. The sampling was carried out in three weeks, immediately after cleaning and disinfection and before starting production. 400 surface samples were collected (glass, stainless steel, aluminum, rubber and plastic), the effectiveness of the sanitation program in controlling the fungal population was also evaluated. All the samples presented fungal counts <10 cfu / cm2, with no significant differences between the types of surfaces, however, the plastic surfaces exhibited higher logarithmic growth of the fungi. It was determined that 49.60% of the identified species corresponded to the Penicillium genus.Although the levels of fungi in the studied baths were lower than the levels recommended by the World Health Organization, some environmental health measure ssuch as washing and disinfecting surfaces after each working shift and periodic inspections are recommended ensuring the safety of the workers and the products that are manufactured there(AU)

Avaliando a redução do tamanho do conglomerado para estimar o volume de madeira em uma floresta amazônica / Assessing reduction of cluster size to estimate wood volume in an Amazonian forest

Enquanto o Inventário Florestal Nacional Brasileiro (IFN) está em andamento, há uma demanda crescente para entender o efeito da área do conglomerado sobre a exatidão e precisão da estimativa de atributos florestais. O objetivo deste estudo foi determinar a área mínima de um conglomerado para estimar o volume comercial (VC) com a mesma acurácia e precisão que as estimativas derivadas do conglomerado original de 8.000 m². A base de dados é proveniente de um inventário realizado em uma unidade florestal (Floresta Nacional do Bom Futuro) no sudoeste da Amazônia brasileira, onde 22 conglomerados foram distribuídos em um desenho amostral em dois estágios. Foram avaliados três produtos: (i) VC de árvores com diâmetro à altura do peito (DAP) ≥ 20 cm (P1); (ii) VC de árvores com DAP ≥ 50 cm (P2); e (iii) VC de espécies comerciais com DAP ≥ 50 cm e qualidade de fuste 'nível 1' ou 'nível 2' (P3). O estudo avaliou dez cenários em que a área do conglomerado foi reduzida de 8.000 a 800 m². A acurácia de P1, P2 e P3 foi significativamente menor para reduções < 2.400 m². A precisão foi mais sensível à variação no tamanho do conglomerado, sobretudo para P2 e P3. Os tamanhos mínimos de conglomerado foram ≥ 2.400 m² para estimar P1, ≥ 4.800 m² para estimar P2 e ≥ 7.200 m² para estimar P3. Concluímos que é possível reduzir a área do conglomerado sem perder acurácia e precisão do conglomerado original do IFN. Um conglomerado de 2.400 m² fornece estimativas com a mesma acurácia que o conglomerado original, independentemente do produto avaliado. (AU)

Gestión integrada para la prevención y control del dengue y otras arbovirosis en la Municipalidad de Ambato / Integrated management for the prevention and control of dengue and other arboviruses in the Municipality of Ambato

Las arbovirosis por Dengue (VD), Zika (VZIK) y Chikungunya (VCHIK), transmitidas por vectores del género Aedes, tienen alta prevalencia en países tropicales, especialmente en Ecuador donde se les considera problemas de salud pública. Se realizó un estudio descriptivo para identificar el nivel de cumplimiento de la estrategia de gestión integrada (EGI) para prevención y control de VD y otros arbovirus en Ambato, Tungurahua - Ecuador. Se realizó perfil comunitario a partir de fuentes oficiales y secundarias, se evaluó componentes del ambiente mediante lista de verificación y se evaluó cumplimiento de EGI mediante encuesta al personal del sector salud. Datos consultados señalan que en la provincia existe 36% y 10% de pobreza y pobreza extrema, respectivamente; además adecuado servicio de agua potable, recepción de agua por tubería, gestión de residuos sólidos y servicio de electricidad en ambas zonas, urbana y rural. Se constató que más del 50% de la población rural presenta condiciones óptimas de salud ambiental: aire limpio (90,28%) y agua potable (66,94%); en la población urbana destaca higiene de alimentos (63,89%) y microambiente doméstico (69,44%), con deficiencia en recolección de residuos sólidos (33,89%). La EGI tuvo un nivel de cumplimiento de 100% en parroquias urbanas en componentes laboratorio, atención al paciente, promoción y comunicación, mientras que en parroquias rurales, salud ambiental tuvo 63% e investigación y capacitación menor nivel (47,78%); siendo necesario mejorar sistemas de desechos sólidos en la población urbana y promover el conocimiento y capacitación epidemiológica en la rural, para reducir el riesgo de transmisión por arbovirus(AU)

Dengue (DV), Zika (ZIKV) and Chikungunya (CHIKV) arboviruses, transmitted by vectors of the Aedes genus, have a high prevalence in tropical countries, especially in Ecuador where they are considered public health problems. A descriptive study was carried out to identify the level of compliance with the integrated management strategy (EGI) for prevention and control of DV and other arboviruses in Ambato, Tungurahua - Ecuador. A community profile was made from official and secondary sources, components of the environment were evaluated by means of a checklist and compliance with EGI was evaluated by means of a survey of health sector personnel. Consulted data indicate that in the province there is 36% and 10% of poverty and extreme poverty, respectively; In addition, adequate drinking water service, receiving water through pipes, solid waste management and electricity service in both urban and rural areas. It was found that more than 50% of the rural population presents optimal environmental health conditions: clean air (90.28%) and drinking water (66.94%); In the urban population, food hygiene (63.89%) and domestic microenvironment (69.44%) stand out, with a deficiency in solid waste collection (33.89%). The EGI had a compliance level of 100% in urban parishes in laboratory, patient care, promotion and communication components, while in rural parishes, environmental health had 63% and research and training lower level (47.78%); being necessary to improve solid waste systems in the urban population and promote epidemiological knowledge and training in rural areas, to reduce the risk of transmission by arbovirus(AU)

Aporte de la gestión de episodios críticos a la reducción de enfermedades respiratorias en las ciudades de Los Ángeles y Chillán, Chile / Contribution of the management of critical air pollution episodes to the reduction of respiratory diseases

Background: In southern Chile cities, the emission of air pollutants, especially the use of firewood for heating is restricted during critical air pollution periods. Aim: To analyze how restrictions applied during the management of air pollution critical episodes have contributed to reduce emergency room admissions for respiratory diseases in two Chilean cities between 2013 and 2019. Material and Methods: Poisson regression models were estimated with daily data including explanatory variables, such as the daily and lag concentration of respirable particulate material (PM10), temperature, relative humidity, rainfall, wind speed, seasonal factors, and implementation of different types of critical episodes. Results: The implementation of restrictions during the management of critical pollution episodes decreased emergency room admissions for upper respiratory infections and bronchial obstructive crises, especially when an environmental emergency was decreed during the critical episode. However, the effect on each group of respiratory diseases was heterogeneous between cities, which could be related to avoidance behavior, indoor air pollution, the composition of PM10, or the presence of other pollutants, and not just a reduction in the daily concentration of PM10. Conclusions: The management of critical pollution episodes with restrictions to pollutant emissions is a useful measure to improve population health in cities that have implemented environmental decontamination plans.

Validación del instrumento sobre manejo de las estrategias de conservación ambiental para reducir, reciclar y reutilizar los desechos sólidos / Validation of the tool on management of environmental conservation strategies to reduce, recycle and reuse solid waste

Las actividades humanas producen un fuerte impacto en la degradación del ambiente. Por tanto, es necesario considerar que, si bien es cierto que en general, los residuos que genera no son tóxicos, su volumen es considerable, produciendo contaminación visual y la rápida colmatación de los vertederos. Objetivo: la presente propuesta de estudio tiene como objetivo validar un instrumento de investigación con el fin de obtener los datos necesarios para diseño de un plan de manejo ambiental y la búsqueda de estrategias para clasificar, reducir, y reutilizar los desechos. Y que autoevalúe el sistema de gestión ambiental, teniendo en cuenta aquellos aspectos relacionados con la normatividad de medio ambiente. Materiales y métodos: El instrumento fue sometido a consideración por juicio de expertos en el tema en el que intervinieron 3 PhDs y 2 especialistas del tema y determinó el grado pertinencia, la validez y la confiabilidad, aplicando el método Delphi que permite encontrar el coeficiente de competencia en forma y contenido. Resultados: Se evidencia que tanto los PhD y los especialistas indican que el instrumento está en la categoría de excelente, por tanto, se puede afirmar que es un instrumento pertinente, válido y confiable para ser aplicado en una prueba piloto. Conclusión: El instrumento presenta validez y confiabilidad aceptable para medir el manejo de las estrategias de conservación ambiental con el fin de reducir, reciclar y reutilizar los desechos sólidos(AU)

Human activities produce a strong impact on the degradation of the environment. Therefore, it is necessary to consider that, although it is true that in general, the waste generated is not toxic, its volume is considerable, producing visual pollution and the landfills rapid clogging. Objective: The purpose of this study proposal is to validate a research instrument in order to obtain the necessary data for the design of an environmental management plan and the search for strategies to classify, reduce and reuse waste. In addition, to self-evaluate the environmental management system, taking into account those aspects related to environmental regulations. Materials and methods: The instrument was submitted to the judgment of experts in the subject, in which three PhDs and two specialists in the subject participated and determined the degree of relevance, validity and reliability, applying the Delphi method that allows finding the coefficient of competence in form and content. The results: It is evident that both the PhDs and the specialists indicate that the instrument is in the excellent category; therefore, it can be affirmed that it is a pertinent, valid and reliable instrument to be applied in a pilot test. Conclusion: The instrument presents acceptable validity and reliability to measure the management of environmental conservation strategies to reduce, recycle and reuse solid waste(AU)

A vigilância de ambientes e processos de Trabalho na prevenção da Covid-19 na Bahia / The surveillance of work environments and processes in the prevention of Covid-19 in Bahia / La vigilancia de los entornos y procesos laborales en la prevención del Covid-19 en Bahía

Com o advento da pandemia de Covid-19, o olhar da vigilância de ambientes e processos de trabalho tem se voltado para a prevenção e controle de situações que possam favorecer a propagação desse risco biológico nos ambientes de trabalho. Este estudo propõe-se a descrever as intervenções realizadas pela Diretoria de Vigilância e Atenção à Saúde do Trabalhador/Centro Estadual de Referência em Saúde do Trabalhador (Divast/Cesat), voltadas para a prevenção da Covid-19 nos locais de trabalho no estado da Bahia. Trata-se de estudo descritivo, baseado nos relatórios das inspeções realizadas pela Divast/Cesat desde o início da pandemia, em atendimento a denúncias e demandas de trabalhadores, de conselhos regionais, da Ouvidoria do SUS e do Ministério Público do Trabalho. Inicialmente, foram produzidos roteiro de inspeção e formulário de notificação para a identificação de situações e fatores de risco para a Covid-19. Foram realizadas 53 inspeções, cerca de metade em serviços de saúde. Identificou-se diversas situações que poderiam contribuir para a propagação da Covid-19 nos ambientes de trabalho: número insuficiente/ou inadequação de medidas de prevenção e de proteção coletiva e individual, como máscaras e álcool em gel a 70%; desrespeito ao distanciamento mínimo recomendado; falta de protocolos ou planos de contingência para nortear o processo de trabalho frente a essa nova realidade, entre outras. Medidas de proteção foram recomendadas no intuito de corrigir as inadequações encontradas e, dessa forma, conter ou prevenir a incidência de casos de Covid-19 nos locais de trabalho.

Due to the Covid-19 pandemic, the workplaces surveillance has focused on prevention and control measures to avoid situations that may favor spreading the biological risk in workplaces. This study describes the interventions made by the Worker's Health Care and Surveillance State Office (Divast/Cesat) aimed at preventing Covid-19 cases in the workplace, in the state of Bahia. This is a descriptive study based on the reports of inspections conducted by Divast/Cesat since the beginning of the Covid-19 pandemic. Inspection script and notification forms were produced as guides for identification and indication of situations and risk factors for Covid-19. The interventions covered several productive branches and in all of them, several situations were identified that could contribute to the spread of Covid-19 in workplaces, such as insufficient number of collective preventive measures to protect against the SARS-Cov-2 virus namely masks and 70% alcohol gel; disrespect to the recommended minimum distance; lack of protocols or contingency plans to guide the work process in this new reality, among other problems. Based on these findings, protective measures were recommended to correct the inadequacies and, thus, contain or prevent the incidence of Covid-19 cases in workplaces.

Con la aparición de la pandemia del Covid-19, la vigilancia de los ambientes y procesos laborales se ha orientado hacia la prevención y control de situaciones que puedan favorecer la propagación de este riesgo biológico en los ambientes laborales. El presente estudio tiene como objetivo describir las intervenciones realizadas por la Dirección de Vigilancia y Atención de la Salud de los Trabajadores/Centro Estadual de Referencia de Salud de los Trabajadores (Divast/Cesat) orientadas a la prevención del Covid-19 en el lugar de trabajo, en el estado de Bahía (Brasil). Es un estudio descriptivo de los informes de inspecciones realizados por Divast/Cesat, desde el inicio de la pandemia, que reciben denuncias y demandas de trabajadores, de comisiones regionales, de la Defensoría del Pueblo del SUS y del Ministerio Público del Trabajo. Se produjo un guion de inspección y un formulario de notificación para identificar e indicar situaciones y factores de riesgo del Covid-19. Se realizaron 53 inspecciones, de las cuales cerca de la mitad fue en servicios de salud. Se identificaron varias situaciones que podrían contribuir a la propagación de esa enfermedad en el ambiente laboral: el número insuficiente de medidas preventivas y de protección colectivas e individuales, como mascarillas y gel de alcohol al 70%; falta de respeto a la distancia mínima recomendada; falta de protocolos o planes de contingencia para orientar el proceso de trabajo ante esta nueva realidad, entre otras. Se recomiendan medidas de protección para corregir las deficiencias encontradas y, así, contener o prevenir la incidencia de casos del Covid-19 en los ambientes laborales.

Negative impacts of mining on Neotropical freshwater fishes

Mining activities have significantly affected the Neotropical freshwater ichthyofauna, the most diverse in the world. However, no study has systematized knowledge on the subject. In this review, we assembled information on the main impacts of mining of crude oil, gold, iron, copper, and bauxite on aquatic ecosystems, emphasizing Neotropical freshwater fishes. The information obtained shows that mining activities generate several different disturbances, mainly via input of crude oil, metals and other pollutants, erosion and siltation, deforestation, and road construction. Mining has resulted in direct and indirect losses of fish diversity in several Neotropical waterbodies. The negative impacts on the ichthyofauna may change the structure of communities, compromise entire food chains, and erode ecosystem services provided by freshwater fishes. Particularly noteworthy is that mining activities (legal and illegal) are widespread in the Neotropics, and often located within or near protected areas. Actions to prevent and mitigate impacts, such as inspection, monitoring, management, and restoration plans, have been cursory or absent. In addition, there is strong political pressure to expand mining; if - or when - this happens, it will increase the potential of the activity to further diminish the diversity of Neotropical freshwater fishes.(AU)

As atividades de mineração têm impactado significativamente a ictiofauna de água doce Neotropical, a mais diversa do mundo. Porém, nenhum estudo sistematizou o conhecimento sobre o assunto. Nesta revisão, reunimos informações sobre os principais impactos da mineração de petróleo, ouro, ferro, cobre, e bauxita sobre os ecossistemas aquáticos, com ênfase nos peixes de água doce Neotropicais. As informações obtidas mostram que as atividades de mineração geram diferentes distúrbios, principalmente por meio de petróleo bruto, metais e outros poluentes, erosão e assoreamento, desmatamento e construção de estradas. A mineração resultou em perda direta e indireta de diversidade de peixes de vários corpos d'água Neotropicais. Os impactos negativos sobre a ictiofauna podem alterar a estrutura das comunidades, comprometer cadeias alimentares inteiras, bem como degradar os serviços ecossistêmicos fornecidos pelos peixes de água doce. Particularmente importante é que as atividades de mineração (legais e ilegais) são generalizadas na região Neotropical, e frequentemente estão localizadas dentro ou perto de áreas protegidas. Ações de prevenção e mitigação de impactos, como planos de fiscalização, monitoramento, manejo e restauração, têm sido precárias ou ausentes. Além disso, há forte pressão política para expandir a mineração; se - ou quando - isso acontecer, aumentará o potencial da atividade em diminuir ainda mais a diversidade de peixes de água doce Neotropicais.(AU)

Guía para el cumplimiento de la meta 6 del programa de incentivos a la mejora de la gestión municipal correspondiente al 31 de diciembre del año 2021: Regulación del funcionamiento de los mercados de abastos para la prevención y contención del COVID-19 / Guide for the fulfillment of goal 6 of the incentive program for the improvement of municipal management corresponding to December 31, 2021: Regulation of the operation of food markets for the prevention and containment of COVID-19

La publicación describe las pautas y procedimientos a seguir por todas las municipalidades tipo A y C, y para las municipalidades priorizadas de tipo D, para el correcto cumplimiento de la Meta 6 "Regulación del funcionamiento de los mercados de abastos para la prevención y contención del COVID-19" del Programa de Incentivos a la Mejora de la Gestión Municipal del año 2021

Recomendações preventivas em tempos de covid-19 à luz da teoria ambientalista / Recomendaciones preventivas en tiempos de COVID-19 a la luz de la teoría ambiental / Preventive recommendations during COVID-19 times in the light of the environmental theory

Objetivo: refletir sobre as recomendações preventivas de isolamento/distanciamento social, higienização do ambiente e das mãos em tempos de covid-19 à luz da teoria ambientalista de Florence Nightingale. Síntese de conteúdo: no contexto da covid-19, as interações físicas entre as pessoas diminuíram, especialmente, em virtude do isolamento/distanciamento social como medida de prevenção da propagação do novo coronavírus. Além disso, práticas de higienização das mãos e do ambiente se intensificaram, sendo resgatada, na teoria ambientalista, a relação doente-ambiente e enfermeiro-ambiente. Esses aspectos devem ser considerados na interação das pessoas com o ambiente a fim de prevenir a transmissão viral. Conclusões: em face do atual momento pandêmico, esta reflexão contribui para que as pessoas se utilizem das ideias tratadas na teoria ambientalista de Florence Nightingale com vistas à adoção das recomendações de isolamento/distanciamento social e às práticas de higiene do ambiente e das mãos.

Objetivo: reflexionar sobre las recomendaciones preventivas de aislamiento/distanciamiento social, higiene del ambiente y limpieza de manos en tiempos de COVID-19 a la luz de la teoría ambiental de Florence Nightingale. Síntesis de contenido: durante los tiempos de COVID-19, las interacciones físicas entre las personas disminuyeron, especialmente por las medidas de aislamiento/distanciamiento social. Además, las prácticas de higiene de manos y del ambiente se han intensificado, rescatando, en la teoría ambiental, la relación entre paciente/ambiente y enfermero/ambiente. Esos aspectos deben deben ser considerados en la interacción de las personas con su entorno con miras a prevenir la transmisión viral. Conclusiones: en vista del momento de pandemia actual, esta reflexión busca que las personas apliquen las ideas discutidas en la teoría ambiental de Florence Nightingale en cuanto a la adopción de las recomendaciones de aislamiento/distancia-miento social y las prácticas de higiene del ambiente y de las manos.

Objective: To reflect on the preventive recommendations regarding social isolation/distance, hygiene of the environment and of the hands in times of COVID-19 based on Florence Nightingale's Environmental Theory. Content synthesis: In the days of COVID-19, physical interactions between people in the environment decreased, especially due to social distancing measures. In addition, hygiene practices related to handwashing and the sanitization of the environment have intensified, with the relationship between patient/environment and nurse/environment being rescued through some aspects of the environmental theory that address the interaction of people with their environment with the aim of preventing viral transmission. Conclusions:In view of the current pandemic situation, this reflection contributes to the use of the ideas discussed in Florence Nightingale's environmental theory regarding the adoption of social distancing recommendations and hygiene practices of the environment and people's hands.