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J Occup Environ Hyg ; 18(sup1): S44-S52, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33822692


ResumenLas pantallas faciales son dispositivos que integran el equipo de protección personal utilizados por muchos trabajadores (por ejemplo, médicos, dentistas, veterinarios) para proteger la zona facial y las membranas mucosas asociadas (ojos, nariz, boca) de salpicaduras, rociadas y aspersiones de fluidos corporales. Generalmente, las pantallas faciales no se utilizan solas, sino junto con otro equipo de protección, por lo que se clasifican como equipo de protección personal complementario. Aunque hay millones de potenciales usuarios de pantallas faciales, las directrices para su uso varían en los distintos organismos gubernamentales y sociedades profesionales y existen pocas investigaciones que indaguen sobre su eficacia.

Nat Commun ; 12(1): 1367, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33649338


Effective control of pain management has the potential to significantly decrease the need for prescription opioids following a surgical procedure. While extended release products for pain management are available commercially, the implementation of a device that safely and reliably provides extended analgesia and is sufficiently flexible to facilitate a diverse array of release profiles would serve to advance patient comfort, quality of care and compliance following surgical procedures. Herein, we review current polymeric systems that could be utilized in new, controlled post-operative pain management devices and highlight where opportunities for improvement exist.

Sistemas de Liberación de Medicamentos , Manejo del Dolor , Dolor Postoperatorio/tratamiento farmacológico , Polímeros/química , Analgésicos/administración & dosificación , Analgésicos/uso terapéutico , Animales , Humanos , Control Social Formal
BMC Complement Med Ther ; 21(1): 67, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-33602181


BACKGROUND: This descriptive study provides the first examination of global naturopathic education, regulation and practice frameworks that have potential to constrain or assist professional formation and integration in global health systems. Despite increasing public use, a significant workforce, and World Health Organization calls for national policy development to support integration of services, existent frameworks as potential barriers to integration have not been examined. METHODS: This cross-sectional survey utilized purposive sampling of 65 naturopathic organisations (educational institutions, professional associations, and regulatory bodies) from 29 countries. Organizational representatives completed an on-line survey, conducted between Nov 2016 - Aug 2019. Frequencies and cross-tabulation statistics were analyzed using SPSSv.25. Qualitative responses were hand-coded and thematically analysed where appropriate. RESULTS: Sixty-five of 228 naturopathic organizations completed the survey (29% response rate) from 29 of 46 countries (63% country response rate). Most education programs (68%) were delivered via a national framework. Higher education qualifications (60%) predominated. Organizations influential in education were professional associations (75.4%), particularly where naturopathy was unregulated, and accreditation bodies (41.5%) and regulatory boards (33.8%) where regulated. Full access to controlled acts, and to health insurance rebates were more commonly reported where regulated. Attitude of decision-makers, opinions of other health professions and existing legislation were perceived to most impact regulation, which was globally heterogeneous. CONCLUSION: Education and regulation of the naturopathic profession has significant heterogeneity, even in the face of global calls for consistent regulation that recognizes naturopathy as a medical system. Standards are highest and consistency more apparent in countries with regulatory frameworks.

Educación Profesional , Salud Global , Naturopatía , Práctica Profesional , Control Social Formal , Acreditación , Actitud , Estudios Transversales , Prestación de Atención de Salud , Humanos , Medicina Integral , Organizaciones , Encuestas y Cuestionarios
Cad Saude Publica ; 37(2): e00024620, 2021.
Artículo en Español | MEDLINE | ID: mdl-33624736


This article describes harassment practices in higher education and explains why they are taken for granted, besides documenting forms of resistance reported by some students and professors. From January 2016 to March 2017, nine in-depth interviews were held with students who had experienced harassment at a public school of law in Mexico City, Mexico, besides interviews with three male students and two female professors. The findings suggest that some professors harass selectively, based on dress codes associated with gender stereotypes. Harassment can be viewed as an exemplary punishment with corrective purposes, or part of school discipline and the formation of female students' identity at the institution. The study also detected forms of heteronormative vigilance that take harassment for granted, to the degree that some female students consider it part of a lifestyle to which they have to adapt in order to complete their studies. Other female students have found ways of denouncing harassment, through informal strategies by which they have contributed to exposing and denaturalizing this gender violence. For example, some professors have ordered female students to wear skirts when taking exams, but this order is not always obeyed, and the students that have refused have organized resistance movements. Thus far there has been no intervention by the university administration to guarantee harassment-free spaces for women, which highlights the need to create guidelines and rules for higher education that allow typifying such acts as serious offenses and preventing sexual harassment.

Mayo Clin Proc ; 96(1): 78-85, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33413837


OBJECTIVE: To examine differences in community mobility reduction and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outcomes across counties with differing levels of socioeconomic disadvantage. METHODS: The sample included counties in the United States with at least one SARS-CoV-2 case between April 1 and May 15, 2020. Outcomes were growth in SARS-CoV-2 cases, SARS-CoV-2-related deaths, and mobility reduction across three settings: retail/recreation, grocery/pharmacy, and workplace. The main explanatory variable was the social deprivation index (SDI), a composite socioeconomic disadvantage measure. RESULTS: Adjusted differences in outcomes between low-, medium-, and high-SDI counties (defined by tertile) were calculated using linear regression with state-fixed effects. Workplace mobility reduction was 1.75 (95% CI, -2.36 to -1.14; P<.001) and 3.48 percentage points (95% CI, -4.21 to -2.75; P<.001) lower for medium- and high-SDI counties relative to low-SDI counties, respectively. Mobility reductions in the other settings were also significantly lower for higher-SDI counties. In analyses adjusted for SARS-CoV-2 prevalence on April 1, medium- and high-SDI counties had 1.39 (95% CI, 0.85 to 1.93; P<.001) and 2.56 (95% CI, 1.77 to 3.34; P<.001) more SARS-CoV-2 cases/1000 population on May 15 compared with low-SDI counties, respectively. Deaths per capita were also significantly higher for higher-SDI counties. CONCLUSION: Counties with higher social deprivation scores experienced greater growth in SARS-CoV-2 cases and deaths, but reduced mobility at lower rates. These findings are consistent with evidence demonstrating that economically disadvantaged communities have been disproportionately impacted by the coronavirus disease 2019 pandemic. Efforts to socially distance may be more burdensome for these communities, potentially exacerbating disparities in SARS-CoV-2-related outcomes.

/epidemiología , Neumonía Viral/epidemiología , Condiciones Sociales , Control Social Formal , /mortalidad , Femenino , Humanos , Masculino , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/virología , Factores Socioeconómicos , Estados Unidos/epidemiología
J Nurs Adm ; 51(1): 6-8, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33278194


This article describes the formation of a Regulatory Advisory Council to address regulatory preparedness. The council used quality improvement methods to address data and findings from previous mock surveys and created 2 categories of work, an environment of care and clinical standards group, with checklists and work streams to improve organizational success with regulatory readiness.

Mejoramiento de la Calidad/legislación & jurisprudencia , Control Social Formal/métodos , Humanos , Innovación Organizacional , Mejoramiento de la Calidad/normas , Mejoramiento de la Calidad/tendencias , Encuestas y Cuestionarios
J. negat. no posit. results ; 5(12): 1575-1598, dic. 2020. tab, graf
Artículo en Español | IBECS-Express | IBECS | ID: ibc-FGT-5913


INTRODUCCIÓN: La fibra dietética es un componente nutricional fundamental, destacando su acción moduladora sobre la microbiota intestinal. El consumo de alimentos de origen vegetal y por ende el de la fibra dietética, tanto en España como en otros muchos países, se ha reducido. Los alimentos funcionales parecer ser una buena alternativa alimentaria para paliar este déficit. OBJETIVOS: 1. Revisar el concepto de fibra dietética. 2. Conocer la situación real de consumo de fibra dietética en España y en otros países europeos en diferentes intervalos de edad. 3. Estudiar los efectos principales del consumo de la fibra dietética y en particular de proantocianidinas (PA) con respecto a la microbiota intestinal. 4. Revisar el concepto de alimento funcional y las posibilidades de incorporar fibra dietética y PA a diferentes alimentos de alto consumo. MATERIALES Y MÉTODOS: El principal motor de búsqueda ha sido la base de datos PubMed, aunque también se ha hecho uso de Google Scholar, ResearchGate y sciELO. Se han revisado artículos científicos, libros, e informes en fuentes fiables y contrastadas. También se han consultado documentos oficiales, como el Informe de Consumo de Alimentos en España de 2018, publicado por el Ministerio de Agricultura, Pesca y Alimentación; la página web de la AESAN y los Reglamentos vigentes de alimentación. RESULTADOS: Se confirma que las ingestas reales de fibra dietética en distintos países de la Unión Europea incluyendo a España, son inferiores de las ingestas dietéticas de referencia (IDR) para la mayoría de los intervalos de edad. Esta inadecuación se exacerba al aumentar la edad. En el artículo se proponen estrategias para alcanzar las IDR, en particular incorporando fibra dietética en alimentos de consumo muy frecuente (p.ej. matrices cárnicas). Se revisa el concepto de alimento funcional y aquellas publicaciones que estudian los efectos de las proantocianidinas (PA) en la recuperación de la microbiota intestinal a otra similar a la que poseen individuos sanos. Se comentan los mecanismos mediante los cuales la microbiota es capaz de hidrolizar las PA y liberar metabolitos con acción protectora intestinal y sistémica. CONCLUSIONES: Dado que modificar los hábitos de consumo por parte de la población parece tarea difícil, se plantea la alternativa de formular alimentos funcionales enriquecidos en fibra dietética y PA. La evidencia positiva creciente observada en cárnicos funcionales enriquecidos con fibra de algarrobo rica en PA sugiere la importancia de continuar investigando en este campo y de iniciar la formulación de nuevos alimentos funcionales (p.ej. cereales, cremas, gominolas, etc.) enriquecidos en este tipo de fibra dietética rica en PA, que propicien un adecuado consumo y los beneficios de sus propiedades funcionales

INTRODUCTION: Dietary fiber is an essential nutritional component, which, its modulating action on gut microbiota must be outlined. The consumption of foods of vegetable origin, and therefore, the dietary's fiber consumption, in Spain, as well as in some other countries, has been reduced. Functional foods have been found to be a great food alternative to solve this dietary deficiency. OBJECTIVES: 1. To review dietary's fiber concept. 2. To get to know the real consumption situation of dietary fiber in Spain, in other European countries; in different age groups. 3. To study the main effects related to dietary fiber consumption, particularly the effects of PA with respect to the gut microbiome. 4. To revise functional foods concept, and the possibilities of incorporating dietary fiber and PA into different highly consumed foods. MATERIALS AND METHODS: The main research engine has been the PubMed database, although it has also been used Google Scholar, ResearchGate and SciELO. At the same time scientific articles, books and reports from reliable and corroborated sources have been revised. In addition, official documents have been consulted, as the 2018 Spanish Foods Consumption Report, published by the Spanish Ministry of Agricultura, Pesca y Alimentación; the AESAN website, and the current food regulations. RESULTS: It is proved that the real dietary fiber intakes in different European countries, including in Spain, are far below the dietary reference intakes (DRI), in most of the studied age ranges. In this article, there are proposed strategies to achieve these DRI, particularly adding dietary fiber into highly consumed foods (i.e. meat matrices). The concept of functional foods is reviewed, and some of the most relevant publications reporting the effects of proanthocyanidins (PA) in relationship to the gut microbiome recovery, and its change to another related to the healthy people's microbiome. The mechanisms by which the gut microbiome is able to hydrolyse the PA, and consequently release metabolites with gut and systemic protective activity, is also discussed. CONCLUSIONS: Given that modifying the population consumption habits seems a difficult task, the alternative of formulating functional foods enriched with dietary fiber and PA it is suggested. The increasing positive evidence observed derived from the consumption of functional meat products to which carob fruit fiber has been added, suggests the relevance of continuing investigating on this field, and therefore start the formulation of new functional foods (i.e. cereals, creams, sweets, etc.) enriched with this PA-enriched fiber, which would lead to an adequate dietary fiber consumption and the benefits from its functional functions

Rev. Saúde Pública Paraná (Online) ; 3(supl. 1): 189-197, dez. 11, 2020.
Artículo en Portugués | LILACS, Coleciona SUS, CONASS, SESA-PR | ID: biblio-1151228


Estudo descritivo, em formato de comunicação breve, com o objetivo de relatar ajustes efetuados no Sistema Estadual de Regulação no período de março a julho/agosto de 2020, que possibilitam o levantamento de dados relacionados com Covid-19. As informações foram levantadas a partir de anotações pessoais das reuniões, planilhas setoriais, comunicados oficiais e alterações observadas no referido sistema. Algumas adequações realizadas foram criação de novos campos, relatórios e integração entre sistemas de uso estadual. Com isso, permitiu-se acesso a dados e informações que formam uma base mais consistente para tomar decisões no enfrentamento da pande-mia causada pela Covid-19. (AU)

Descriptive study, in a brief communication format, with the objective of reporting adjustments made in the State Regulation System in the period from March to July/August 2020, which make it possible to survey data related to Covid-19. The information was gathered from personal notes of meetings, sector spreadsheets, official communications and changes observed in that system. Some adjustments were made to create new fields, reports, and integration between state use systems. This allowed access to data and information that form a more consistent basis to make decisions in facing the pandemic caused by Covid-19. (AU)

Control Social Formal , Salud Pública , Infecciones por Coronavirus , Información , Informe de Investigación
Cad. Ibero Am. Direito Sanit. (Impr.) ; 9(4): 70-88, out.-dez.2020.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1141050


Objetivo: analizar la implementación y comercialización de medicamentos de alto costo en el sistema de salud argentino, tomando como referencia el tratamiento médico de la enfermedad de atrofia muscular espinal y analizar la normativa aplicable, demonstrando el paralelismo legislativo con la República Federativa del Brasil. Metodología: se realizó una investigación descriptiva analítica identificando los criterios plasmados en las normas ó reglamentos para la implementación de una medicación de alto costo. Resultados: logramos obtener el marco regulatorio de la medicación denominada nusinersen en Argentina y la República Federativa del Brasil. Conclusión: con el avance de la tecnología, sus altos costos impactan directamente en la posibilidad de acceso, ante lo cual creemos que además de las herramientas de negociación interna de cada país, la cooperación internacional resulta una herramienta fundamental para transformar esta realidad en una oportunidad de acceso.

Objective: to analyze the implementation and commercialization of high-cost drugs in the Argentine health system, taking as a reference the medical treatment of spinal muscular atrophy disease and analyze the applicable regulations, demonstrating the legislative parallelism with the Federative Republic of Brazil. Methods: a descriptive analytical investigation was conducted to identify the criteria set out in the rules or regulations for the implementation of a high-cost medication. Results: we obtained the regulatory framework for the medication called nusinersen in Argentina and the Federative Republic of Brazil. Conclusion: with the advancement of technology, its high costs have a direct impact on the possibility of access, before which we believe that in addition to the internal negotiation tools of each country, international cooperation is a fundamental tool to transform this reality into an opportunity access.

Objetivo: analisar a implantação e comercialização de medicamentos de alto custo no sistema de saúde argentino, tomando como referência o tratamento médico da doença atrofia muscular espinhal; e analisar a regulamentação aplicável, demonstrando o paralelismo legislativo com a República Federativa do Brasil. Metodologia: foi realizada uma pesquisa descritiva analítica, identificando os critérios previstos nas normas ou regulamentos para a implantação de um medicamento de alto custo. Resultados: obtivemos o marco regulatório do medicamento denominado nusinersen na Argentina e na República Federativa do Brasil. Conclusão: os altos custos da tecnologia impactam diretamente no seu acesso. Acreditamos que, além dos instrumentos de negociação interna de cada país, a cooperação internacional é uma ferramenta fundamental para transformar essa realidade em oportunidade de acesso.

RECIIS (Online) ; 14(4): 970-982, out.-dez. 2020. ilus, tab
Artículo en Portugués | LILACS | ID: biblio-1145573


O objetivo deste estudo foi analisar a utilização dos Sistemas de Informação em Saúde para a construção da sala de situação na Atenção Primária à Saúde. Trata-se de uma revisão integrativa realizada por meio de busca de artigos na íntegra, nas bases de dados BDENF, Lilacs, Medline, SciELO, PubMed e Cochrane. Foram analisados sete artigos, os quais foram apresentados em três categorias. Os sistemas de informação apoiam a sala de situação na coleta, no processamento e na divulgação de resultados, na análise e na comparação de indicadores, no planejamento, na gestão e na avaliação em saúde. Por fim, percebeu-se que os sistemas de informação contribuem para a construção da sala de situação subsidiando a atuação da gestão local na formação de indicadores de saúde e na implementação de ações.

The aim of this study was to analyze the use of Health Information Systems in the construction of the situation room in Primary Health Care. This is an integrative review performed by searching full articles in the BDENF, Lilacs, Medline, SciELO, PubMed and Cochrane databases. Seven articles were analyzed and presented in three categories. Information systems support the situation room in the collection, processing and dissemination of results, in the analysis and comparison of indicators, and in the health planning, management and evaluation. In the end, we realized that information systems contribute to the construction of the situation room, supporting local management actions in the establishment of health indicators and the implementation of actions.

El objetivo de este estudio fue analizar el uso de los Sistemas de Información de Salud en la construcción de la sala de situación en Atención Primaria de Salud. Esta es una revisión integradora realizada mediante la búsqueda de artículos completos en las bases de datos BDENF, Lilacs, Medline, SciELO, PubMed y Cochrane. Siete artículos fueron analizados y presentados en tres categorías. Los sistemas de información apoyan la sala de situación en la recolección, lo procesamiento y la difusión de resultados, en la análisis y la comparación de indicadores, y en la planificación, gestión y evaluación de la salud. Finalmente, se dio cuenta de que los sistemas de información contribuyen a la construcción de la sala de situación, apoyando las acciones de gestión local en lo establecimiento de indicadores de salud y la implementación de acciones.

Humanos , Atención Primaria de Salud , Evaluación en Salud , Diagnóstico de la Situación de Salud , Gestión en Salud , Sistemas de Información en Salud , Control Social Formal , Sistema Único de Salud , Indicadores de Salud , Personal de Salud , Gestión de la Información en Salud
Nutrients ; 12(11)2020 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-33167515


Past public health crises (e.g., tobacco, alcohol, opioids, cholera, human immunodeficiency virus (HIV), lead, pollution, venereal disease, even coronavirus (COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the global pandemic of non-communicable diseases (NCDs) has its origins in our Western ultraprocessed food diet, society has been slow to initiate any interventions other than public education, which has been ineffective, in part due to food industry interference. This article provides the rationale for such public health interventions, by compiling the evidence that added sugar, and by proxy the ultraprocessed food category, meets the four criteria set by the public health community as necessary and sufficient for regulation-abuse, toxicity, ubiquity, and externalities (How does your consumption affect me?). To their credit, some countries have recently heeded this science and have instituted sugar taxation policies to help ameliorate NCDs within their borders. This article also supplies scientific counters to food industry talking points, and sample intervention strategies, in order to guide both scientists and policy makers in instituting further appropriate public health measures to quell this pandemic.

Conducta Adictiva/prevención & control , Dieta , Azúcares de la Dieta/efectos adversos , Comida Rápida/efectos adversos , Industria de Alimentos/legislación & jurisprudencia , Enfermedades no Transmisibles/prevención & control , Salud Pública , Conducta Adictiva/etiología , Infecciones por Coronavirus , Conducta Alimentaria , Manipulación de Alimentos/legislación & jurisprudencia , Humanos , Obesidad/etiología , Obesidad/prevención & control , Pandemias , Neumonía Viral , Política Pública , Control Social Formal , Impuestos
New Bioeth ; 26(4): 328-350, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33196403


United States law recognizes adult reproductive liberty and many states view surrogacy services through that lens. During the COVID-19 pandemic in March, 2020, New York State enacted the Child-Parent Surrogacy Act (CPSA) into law, after feminists and their allies had caused its defeat in 2019. Just before approval of the CPSA, a group of legislators introduced the Alternative Surrogacy Bill (ASB). This article is a case study that examines how the CPSA and not the ASB became law, examining surrogate rights, the best interests of the child, and the ethical issues related to adult donor-conceived and surrogacy born children's rights to information about their ancestry.

Comercio/legislación & jurisprudencia , Derechos Humanos , Legislación Médica/ética , Técnicas Reproductivas/legislación & jurisprudencia , Control Social Formal , Madres Sustitutas/legislación & jurisprudencia , Acceso a la Información , Adulto , Niño , Bienestar del Niño , Comercio/ética , Infecciones por Coronavirus/epidemiología , Disentimientos y Disputas , Familia , Femenino , Humanos , Industrias/ética , Industrias/legislación & jurisprudencia , Madres , New York/epidemiología , Pandemias , Neumonía Viral/epidemiología , Embarazo , Técnicas Reproductivas/economía , Técnicas Reproductivas/ética , Derechos de la Mujer
Rev. bioét. derecho ; (50): 5-17, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191343


La epidemia de la COVID-19 ha puesto en primer plano tensiones entre valores que se sintetizan en un dilema ético-político clásico: "seguridad-libertad" o "la salud como bien común-la salvaguarda de las libertades individuales". Al tratarse de una emergencia sociosanitaria, las medidas para su contención implican costes y sacrificios. También restricciones de derechos y libertades básicas. Determinar quién tiene que cargar con los costes se convierte en una cuestión acuciante con implicaciones morales. En este artículo, se plantea un ejercicio de filosofía aplicada a la salud pública en ocasión de esta pandemia y, a su vez, una genealogía de la relación entre la salud y la solidaridad basada en la máxima ciceroniana salus populi suprema lex esto

The COVID-19 epidemic has brought to the fore tensions between values that are synthesized in a classic ethical-political dilemma: "security-freedom" or "health as a common good-the safeguard of individual liberties". As it is a socio-sanitary emergency, the measures for its containment involve costs and sacrifices. Also, restrictions on basic rights and freedoms. Determining who has to bear the costs and what their magnitude should be becomes a pressing question with moral implications. In this article, an exercise in philosophy applied to public health is presented on the occasion of this pandemic and, in turn, a genealogy of the relationship between health and solidarity based on the Ciceronian maxim salus populi suprema lex esto

L'epidèmia de la COVID-19 ha posat en primer pla tensions entre valors recollits en un dilema ètico-polític clàssic: "seguretat-llibertat" o "la salut com a bé comú-la salvaguarda de les llibertats individuals". Quan es tracta d'una emergència sociosanitària, les mesures per a la seva contenció impliquen costos I sacrificis. També restriccions de drets I llibertats bàsiques. Determinar qui ha de carregar amb els costos esdevé una qüestió urgent amb implicacions morals. En aquest article, es planteja un exercici de filosofia aplicada a la salut pública en qüestió d'aquesta pandèmia i, a la vegada, una genealogia de la relació entre la salut I la solidaritat basada en la màxima ciceroniana salus populi suprema lex esto

Humanos , Derecho a la Libre Circulación , Cuarentena , Control Social Formal , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Pandemias