Análisis de interacciones de los actores de la red de conocimiento en salud ambiental del Observatorio Nacional de Salud de Colombia

Introducción: Las interrelaciones positivas y negativas entre el hombre y el medioambiente impactan en la salud general de la población, por esto, la gestión del conocimiento y la transformación social, orientadas a la prevención de la exposición a factores de riesgo ambiental y a la creación de ambientes propicios, deben realizarse a través de acciones multidisciplinares intersectoriales, como el trabajo colaborativo de redes del conocimiento. Objetivo: Describir las interacciones entre los actores de la Red de Conocimiento de Salud Ambiental del Observatorio Nacional de Salud de Colombia (ONS), con el fin de promover, mejorar y fortalecer la colaboración, intercambio de información y planificación conjunta de acciones. Metodología: Estudio descriptivo transversal de análisis de redes sociales mediante herramientas de minería de texto del lenguaje de programación R. Se analizaron las categorías de agua y saneamiento, clima, calidad del aire, radiaciones electromagnéticas e intoxicaciones químicas de un corpus documental de 99 textos de los actores de la red general de conocimiento en salud pública del ONS. Se calcularon medidas de centralidad y prestigio y se graficaron redes dirigidas multicapa con Power BI. Resultados: Los actores con mayor centralidad en la red fueron: Ministerio de Salud y Protección Social, Superintendencia de Salud, Profamilia, universidades de Antioquia y La Salle, ONS, Observatorio de Salud Ambiental de Bogotá, Organización Panamericana de la Salud y Organización Mundial de la Salud. Las cinco categorías analizadas presentaron bajas centralidades de grado, y las categorías de agua y clima mostraron mayor participación de los actores (más nodos e interacciones). Conclusiones: El análisis de redes sociales permitió identificar temas relevantes de salud ambiental entre los actores de la red del ONS, además de actores clave para desarrollar espacios de interacción y gestión del conocimiento. Acorde con las limitaciones del análisis, se sugiere la inclusión de aproximaciones bibliométricas para la actualización de las interacciones de la red.

Introduction: Positive and negative interactions between the human beings and the environment have an impact on the general health of the population. Therefore, it is necessary to use knowledge management and social transformation, in order to limit exposure to environmental risk factors by creating a favorable environment for healthcare. This should be carried out through multidisciplinary and intersectorial actions, such as the collaborative work of knowledge networks. Objective: To describe the interactions between the actors within the Environmental Health Knowledge Network Colombia's National Observatory of Health (ONS acronym in Spanish), in order to promote, improve and strengthen collaboration, information exchange and planning of collaborative actions. Methodology: Cross-sectional descriptive study to analyze social interactions through text mining tools by R, programmer language. Categories analyzed: Water and sanitation, climate, air quality, electromagnetic radiation and chemical poisoning. Data source: a documentary corpus of 99 texts done by actors of Environmental Health Knowledge Network of Colombia's ONS. We calculated centrality and prestige measures. We used Power BI in order to plot multi-layered directed networks. Results: Actors with greatest centrality in the network: Ministry of Health and Social Protection, Health Superintendency, Profamilia, Antioquia and La Salle universities, National Health Observatory, Bogota's Observatory of Environmental Health, the Pan American Health Organization and the World Health Organization. The five categories analyzed provides a low centrality degree, and water and climate categories presented greater participation by actors (more nodes and links). Conclusions: Social interactions analysis provides the identification of relevant environmental health issues in Colombia and key actors in order to develop interaction spaces for knowledge management. The analysis had limitations that suggest the inclusion of bibliometric approaches for updating the interactions within the network.

Evolución 2010-2019 de la mortalidad neonatal en la cuenca Matanza Riachuelo. Comparación con Argentina, provincia de Buenos Aires y Ciudad Autónoma de Buenos Aires, 2019 / Evolution of neonatal mortality in the Matanza-Riachuelo River Basin between 2010 and 2019. A comparison of Argentina, the province of Buenos Aires, and the City of Buenos Aires, 2019

Introducción. La tasa de mortalidad neonatal (TMN) es un indicador de condiciones socioeconómicas, ambientales y sanitarias. La cuenca Matanza Riachuelo (CMR) es la más contaminada de Argentina. Objetivo. Analizar la evolución de la mortalidad neonatal (MN) en la CMR entre los años 2010 y 2019, sus características, y compararla con datos globales de Argentina, de la provincia de Buenos Aires (PBA) y de la Ciudad Autónoma de Buenos Aires (CABA) en 2019. Población y métodos. Estudio descriptivo de estadísticas vitales del Ministerio de Salud de la Nación. Resultados. En 2019, la TMN en la CMR fue del 6,4 ‰; en Argentina, del 6,2 ‰; en PBA, del 6 ‰, y en CABA, del 5,1 ‰. El riesgo de MN en la CMR fue mayor que en CABA (RR: 1,32; IC95% 1,08-1,61). Entre 2010 y 2019, disminuyó la TMN en la CMR, en PBA y en Argentina; pero no en CABA. El riesgo de MN por afecciones perinatales en la CMR fue mayor que en CABA (RR: 1,30; IC95% 1,011,67). El riesgo de muerte para nacidos vivos (NV) con muy bajo peso al nacer (MBPN) en la CMR fue mayor que en CABA (RR: 1,70; IC95% 1,33-2,18) y menor que en Argentina (RR: 0,78; IC95% 0,70-0,87). Conclusión. La evolución 2010-2019 de la TMN fue similar en la CMR, en Argentina y en PBA. En 2019 la estructura de causas y el riesgo de MN fueron similares en la CMR, en PBA y en Argentina, con mayor riesgo por afecciones perinatales y de los NV con MBPN. La TMN de NV de MBPN fue menor en la CMR que en Argentina.

Introduction. The neonatal mortality rate (NMR) is an indicator of socioeconomic, environmental, andhealth care conditions. The Matanza-Riachuelo River Basin (MRRB) is the most polluted in Argentina.Objective. To analyze neonatal mortality (NM) in the MRRB between 2010 and 2019 and compare itwith overall data for Argentina, the province of Buenos Aires (PBA), and the City of Buenos Aires (CABA)in 2019.Population and methods. Descriptive study based on vital statistics provided by the Ministry of Health. Results. In 2019, the NMR was 6.4‰ in the MRRB, 6.2‰ in Argentina; 6‰ in PBA; and 5.1‰ in CABA.The risk of NM in the MRRB was higher than in CABA (RR: 1.32, 95% CI: 1.08­1.61). Between 2010and 2019, the NMR decreased in the MRRB, PBA, and Argentina; but not in CABA.The risk of NM due to perinatal conditions in the MRRB was higher than in CABA (RR: 1.30, 95%CI: 1.01­1.67).The risk of death among very low birth weight (VLBW) live births (LBs) in the MRRB was higher than in CABA(RR: 1.70, 95% CI: 1.33­2.18) and lower than in Argentina (RR: 0.78, 95% CI: 0.70­0.87).Conclusion. The evolution of NMR between 2010 and 2019 was similar in the MRRB, Argentina, andPBA. In 2019, the structure of causes and the risk of NM were similar in the MRRB, PBA, and Argentina,with a higher risk due to perinatal conditions and among VLBW LBs. The NMR among VLBW LBs waslower in the MRRB than in Argentina

Vigilância Popular da Saúde, Ambiente e Trabalho (VPSAT): uma revisão integrativa da literatura / Popular Health, Environmental and Occupational Surveillance: an integrative literature review

Resumo Objetiva-se identificar concepções, experiências, métodos e técnicas em Vigilância Popular da Saúde, Ambiente e Trabalho (VPSAT). Trata-se de uma revisão integrativa com os descritores: participação da comunidade, vigilância em saúde, vigilância da saúde, saúde ambiental e saúde do trabalhador, envolvendo cinco bancos de dados: Biblioteca Virtual da Saúde, EBSCOhost, Embase, Scopus e Web Of Science. A revisão selecionou 15 estudos, a partir dos critérios de inclusão: experiências de vigilância com protagonismo comunitário; e exclusão: pesquisas sem dados primários e desenvolvidas apenas pelo serviço de saúde. Identificaram-se como bases teóricas e metodológicas dos estudos a ciência cidadã, educação popular e justiça ambiental; e experiências como mapeamentos e monitoramentos participativos; métodos como pesquisa-ação, "faça você mesmo" e investigação baseada na comunidade; e técnicas como "Photovoice" e Jornal Comunitário. Destacam-se as comunidades urbanas de baixa renda, indígenas, jovens e trabalhadores como protagonistas. O reconhecimento da VPSAT como importante fonte de dados e de intervenção pelos sistemas de saúde públicos e pela academia contribui para que a vigilância em saúde seja mais dialógica e efetiva.

Abstract The objective is to identify concepts, experiences, methods, and techniques in Popular Health, Environmental and Occupational Surveillance (VPSAT). This is an integrative review that used the descriptors: Community Participation, Public Health Surveillance, Environmental Health, and Occupational Health, using five databases: Virtual Health Library, EBSCOhost, Embase, Scopus and Web of Science. The review selected 15 studies, based on the inclusion criteria: surveillance experiences with community protagonism; and exclusion criteria: research without primary data and developed only by the health service. The theoretical and methodological bases of the studies were identified as citizen science, popular education, and environmental justice; experiences such as participatory mapping and monitoring; methods such as action research, 'do-it-yourself', and community-based research; and techniques such as "Photovoice" and Community Journal. Low-income urban communities, indigenous peoples, young individuals, and workers stand out as the protagonists. The recognition of the VPSAT as an important source of data and intervention by public health systems and academia contributes to making health surveillance more dialogic and effective.

Ambiente, saúde e covid-19: da crise global à existência sustentável / Environment, health, and the COVID-19: from global crisis to sustainable existence

Resumo Este ensaio busca analisar os impactos sociossanitários exercidos pelo meio ambiente, incorporando as dinâmicas trazidas pela covid-19 e evidenciando as repercussões da pandemia. O coronavírus atingiu sobretudo países que falharam na prevenção e não estabeleceram medidas de intervenção eficazes e colaborativas. A destruição da natureza se intensificou na pandemia, assim como as ameaças enfrentadas por seus defensores, o que agravou ainda mais a crise. Nesse contexto pode-se destacar os riscos apresentados aos indígenas brasileiros e aos ambientalistas latino-americanos; o surgimento de grupos perigosos; e a implementação de políticas governamentais de efeitos críticos que afetam a preservação ambiental e colocam em risco os modos de vida tradicionais. Assume-se, desse modo, que o planeta enfrenta uma crise sanitária, mas também socioeconômica e ambiental. Para que tal crise heterogênea seja superada, os esforços precisam ser multiformes, envolvendo: cuidados à saúde e aos ecossistemas; diminuição da pobreza global e da desigualdade sanitária; redução de riscos ambientais; proteção dos modos de vida tradicionais; defesa das democracias e dos direitos humanos; fomento de políticas de desenvolvimento sustentável; e cooperação internacional. Tais esforços também incidirão sobre os anos vindouros, minimizando os riscos de novas pandemias e atuando na preservação ambiental.

Abstract This essay analyzes the socio-sanitary impacts exerted by the environment, incorporating the dynamics brought about by the COVID-19 pandemic and unveiling its repercussions. Countries that failed to prevent the virus spread and to established effective and collaborative intervention measures were hit the hardest. Environmental destruction reached new heights in the pandemic, as have the threats faced by its defenders, further aggravating the crisis. In this scenario one can highlight the risks posed to Brazilian Indigenous peoples and Latin American environmentalists; the emergence of dangerous groups; and the implementation of government policies with critical effects on environmental preservation that put traditional ways of life at risk. It is thus recognized that the planet faces not only a health crisis, but also a socioeconomic and environmental one. To overcome such heterogeneous crisis, efforts must be multifaceted, involving: caring for health and ecosystems; eliminating global poverty and sanitary inequality; reducing environmental risks; protecting traditional ways of life; defending democracies and human rights; and fostering sustainable development policies and international cooperation. These efforts will also affect the years to come, minimizing the risks of new pandemics and acting to preserve the environment.

Desarrollo de habilidades en salud ambiental en asentamientos humanos precarios de la zona de planificación territorial 2 de la parroquia rural Posorja, Guayaquil / Development of skills in environmental health in precarious human settlements in territorial planning zone 2 of the rural parish of Posorja, Guayaquil

Se estima que aproximadamente siete millones de personas mueren anualmente por la contaminación del aire ambiental y doméstico, debido a enfermedades no transmisibles, especialmente en zonas con servicios públicos precarios; además la infraestructura y condiciones de las viviendas o hacinamiento se han asociado a la aparición de enfermedades agudas y crónicas. En Ecuador, para el año 2010, se reportó más de 2,5 millones de personas en zonas de asentamientos irregulares con deficientes saneamiento ambiental. Se realizó un estudio experimental con la participación de 85 jefes de familia en las comunidades de La Unión, Nuestra señora de Lourdes, las Acacias y Brisa del mar, de la parroquia rural Posorja, del cantón Guayaquil, Ecuador, para evaluar el desarrollo de habilidades de saneamiento ambiental. Para ello, se identificaron los problemas y las prioridades en salud ambiental, posteriormente se implementó el plan de desarrollo de habilidades en salud ambiental. Se observó deficiencias en cuanto a la construcción de viviendas, acceso al agua potable, disposición de excretas y desechos sólidos. Además, posterior a las jornadas de capacitación hubo un incremento en las habilidades cognoscitivas y prácticas en salud ambiental, al comparar con las competencias previas, especialmente en aspectos relacionados con el abastecimiento de agua potable, disposición de residuos sólidos y control de fauna nociva. Se logró fortalecer el desarrollo de habilidades en saneamiento ambiental de los habitantes, lo que incide en el mejoramiento de la salud pública y calidad de vida de las comunidades en estudio(AU)

It is estimated that approximately seven million people die annually from environmental and domestic air pollution, due to non-communicable diseases, especially in areas with precarious public services; In addition, the infrastructure and conditions of the houses or overcrowding have been associated with the appearance of acute and chronic diseases. In Ecuador, for the year 2010, more than 2.5 million people were reported in areas of irregular settlements with deficient environmental sanitation. An experimental study was carried out with the participation of 85 heads of families in the communities of La Unión, Nuestra Señora de Lourdes, Las Acacias and Brisa del Mar, from the Posorja rural parish, from the Guayaquil canton, Ecuador, to evaluate the development of skills of environmental sanitation. In order to, environmental health problems and priorities were identified, and the environmental health skills development plan was subsequently implemented. Deficiencies were observed in terms of housing construction, access to drinking water, disposal of excreta and solid waste. In addition, after the training sessions, there was an increase in cognitive skills and practices in environmental health, when compared to previous skills, especially in aspects related to drinking water supply, solid waste disposal, and control of harmful fauna. It was possible to strengthen the development of skills in environmental sanitation of the inhabitants, which affects the improvement of public health and quality of life of the communities under study(AU)

Consultorio de Salud Ambiental en un Hospital Privado de Comunidad de la Ciudad de Buenos Aires / Environmental Health consulting office in a Private Community Hospital of the Buenos Aires City

En los últimos años surge el concepto de Una Sola Salud que reconoce la interdependencia sistémica al observar que los cambios en la salud humana se expresan de manera sincrónica e indivisible de la salud del ambiente. Nuevas enfermedades y daños crónicos inespecíficos ocurren a la par de la pérdida de biodiversidad y vitalidad. En las últimas décadas venimos observando el surgimiento de "adaptaciones sistémicas" que requieren un abordaje desde la clínica y la toxicología a nivel individual y desde la epidemiología de la complejidad a nivel poblacional. Luego de un largo recorrido de investigaciones, el Hospital Italiano formalizó el consultorio de Salud Ambiental con la intención de brindar respuesta a la demanda de pacientes que atribuyen síntomas y signos a la polución ambiental. (AU)

In recent years, the concept of One Health has emerged, recognizing the systemic interdependence and the changes in human health that are expressed synchronously and indivisible from the environment. New diseases and nonspecific chronic damage are occuring in parallel with the loss of biodiversity and vitality.In recent decades we have observed the appearance of "systemic adaptations" that require a clinical and toxicological approach at the individual level, and address the population level from an epidemiological and complexity science paradigm. After many years of research, the Hospital Italiano de Buenos Aires formalized the Environmental Health consulting office and the measurement of glyphosate levels, giving answer to the demand of patients who associate their signs and symptoms to environmental pollution. (AU)

Satisfacción y percepciones sobre aspectos de la ciudad que afectan la salud, por nivel socioeconómico, 2010-2019, en Lima Metropolitana / Satisfaction and perceptions about aspects of the city that affect health, by socioeconomic status, 2010-2019, in Lima

RESUMEN Se buscó caracterizar la satisfacción y percepciones de los residentes de Lima Metropolitana sobre distintos aspectos de la ciudad que pueden afectar su calidad de vida y salud, identificando diferencias por nivel socioeconómico (NSE) y cambios en el tiempo. Se realizó un análisis secundario de la Encuesta «Lima Cómo Vamos¼ entre 2010 y 2019, reportando los resultados mediante porcentajes, con diferencias entre NSE para cada año y entre años. En 2019 la satisfacción y percepciones eran mayoritariamente desfavorables, y han disminuido hasta en 30 puntos porcentuales con el tiempo. Las personas de NSE más bajos tenían valoraciones más desfavorables y con mayores reducciones en el tiempo. Esta insatisfacción y percepciones desfavorables revelan deficiencias en servicios públicos y condiciones urbanas que podrían afectar negativamente la calidad de vida y salud, haciendo necesarias políticas que reduzcan las brechas socioeconómicas y mejoren la salud de los ciudadanos de Lima Metropolitana.

ABSTRACT We aimed to characterize the satisfaction and perceptions of the residents of Lima about different aspects of urban life that can affect their quality of life and health, identifying differences by socioeconomic status (SES) and changes over time. A secondary data analysis of the "Lima Cómo Vamos" survey was conducted between 2010 and 2019. Results are reported through percentages, with differences between SES for each year and between years. In 2019, satisfaction and perceptions were mostly unfavorable, and have decreased by up to 30% over time. People with lower SES had more unfavorable evaluations and with greater reductions over time. This dissatisfaction and unfavorable perceptions reveal deficiencies in public services and urban conditions that could negatively affect the quality of life and health, making it necessary to design and implement policies that reduce socioeconomic gaps and improve the health of Lima citizens.

Actitudes de la enfermería comunitaria ante intervenciones ambientales para la promoción de la salud / Community nursing attitudes towards environmental interventions for health promotion

Un estimado de 12 millones y medio de muertes anuales, las cuales representan casi la cuarta parte de la letalidad global, se atribuyen a ambientes no saludables. La OMS identificó factores medioambientales susceptibles a gestión o cambio, que pueden ser modificados mediante intervenciones clave, a fin de disminuir la morbimortalidad de un centenar de enfermedades o afecciones. Este estudio tuvo como finalidad comparar y analizar las actitudes del personal de enfermería comunitaria sobre intervenciones ambientales para la prevención de enfermedades infecciosas y parasitarias, condiciones neonatales y nutricionales, y enfermedades no transmisibles; ya que en la medida que estuvieran predispuestos y tuvieran una actitud positiva hacia las intervenciones, esto debería influir en su conducta proactiva y en sus próximas actividades de promoción de la salud. La muestra final de 158 participantes estuvo compuesta por 21 enfermeros y 137 enfermeras, con edades comprendidas entre 22 y 53 años, con una mediana de 29 años (±6,74). Para la elaboración del cuestionario de actitudes se tomó como base la sección "Enfermedades y lesiones e intervenciones ambientales clave" del informe global de la OMS titulado "Prevenir enfermedades mediante ambientes saludables" Se obtuvieron los índices de actitud por intervención y categoría de acuerdo al modelo propuesto por Manassero & Vásquez. Los resultados mostraron que los índices actitudinales, para la categoria "adecuada" son positivos y los más altos, ligeramente positivos los de las plausible y levemente negativos para "ingenuas", es decir, los enfermeros, pueden identificar acciones adecuadas con mayor facilidad, se le dificulta identificar las frases plausibles y más las ingenuas. Lo que permite comprobar que las actitudes de los enfermeros pueden ser paradójicas y confusas. Siendo evidente la necesidad de realizar sesiones educativas continúos y acorde con las actualizaciones científicas y políticas internacionales y nacionales. Se recomienda incluir la reflexión explícita y personal como instrumento básico para lograr el cambio actitudinal(AU)

An estimated of 12.5 million annual deaths, which represent nearly a quarter of global fatalities, are attributed to unhealthy environments. WHO identified environmental factors susceptible to management or change, which can be modified through key interventions, in order to reduce the morbidity and mortality of a hundred diseases or conditions. The purpose of this study was to compare and analyze the attitudes of community nursing staff regarding environmental interventions for the prevention of infectious and parasitic diseases, neonatal and nutritional conditions, and non-communicable diseases; since to the extent that they were predisposed and had a positive attitude towards the interventions, this should influence their proactive behavior and their next health promotion activities. The final sample of 158 participants was made up of 21 male nurses and 137 female nurses, aged between 22 and 53 years, with a median of 29 years (±6.74). For the elaboration of the questionnaire of attitudes, the section "Diseases and injuries and key environmental interventions" of the WHO global report entitled "Preventing diseases through healthy environments" was taken as a basis. Attitude indices were obtained by intervention and category according to the model proposed by Manassero & Vásquez. The results showed that the attitudinal indices for the "adequate" category are positive and the highest, slightly positive for the plausible and slightly negative for "naive", that is, the nurses, can more easily identify appropriate actions, It makes it difficult for him to identify plausible sentences and more naive ones. This allows verifying that nurses' attitudes can be paradoxical and confusing. Being evident the need to carry out continuous educational sessions and in accordance with international and national scientific and political updates. It is recommended to include explicit and personal reflection as a basic instrument to achieve attitudinal change(AU)

Environmental impact of inhaler devices on respiratory care: a narrative review / Impacto ambiental dos dispositivos inalatórios nos cuidados respiratórios: uma revisão narrativa

ABSTRACT Climate change is a huge and present threat to human health. This article aims to deepen the knowledge about the environmental impact of inhaler devices on their carbon footprint for patients and health professionals, providing information that allows a better choice of the type of device to be prescribed for the treatment of asthma and COPD. This narrative and nonsystematic review was carried out by searching databases (PubMed, Google Scholar, SciELO, and EMBASE) for articles published between 2017 and 2022, written in Portuguese or in English, using the search words "inhalation device" OR "environmental." The review showed that global warming cannot be addressed by focusing only on inhaler devices. However, the devices that we use to treat respiratory diseases such as asthma and COPD, which are diseases that are aggravated by climate change, are also causing that change. Therefore, health professionals, patient organizations, and industries should take a lead in health policies to offer affordable alternatives to inhalers containing hydrofluoroalkane.

RESUMO As mudanças climáticas são uma ameaça enorme e presente para a saúde humana. Este artigo visa aprofundar o conhecimento sobre o impacto ambiental dos dispositivos inalatórios na pegada de carbono para pacientes e profissionais de saúde, fornecendo informações que permitem uma melhor escolha do tipo de dispositivo a ser prescrito para o tratamento da asma e da DPOC. Esta revisão narrativa e não sistemática foi realizada por meio de busca nas bases de dados PubMed, Google Acadêmico, SciELO e EMBASE de artigos publicados entre 2017 e 2022, escritos em português ou inglês, utilizando as palavras de busca "inhalation device" OR "environmental". A revisão mostrou que o aquecimento global não pode ser abordado com foco em dispositivos inalatórios apenas. No entanto, os dispositivos que utilizamos para tratar doenças respiratórias como asma e DPOC, que são doenças agravadas pelas mudanças climáticas, também estão causando essa mudança. Portanto, profissionais de saúde, organizações de pacientes e indústrias devem assumir a liderança nas políticas de saúde para oferecer alternativas acessíveis aos inaladores contendo hidrofluoralcano.

Conocimientos, actitudes y prácticas sobre salud ambiental en estudiantes universitarios / Knowledge, attitudes, and practices on environmental health in university students

La crisis ambiental es la primera crisis global generada por el desconocimiento, es por ello, que la educación respecto a la salud ambiental es el punto de partida para reemplatear la actitud de las relaciones del ser humano con su entorno. Por tal razón, esta investigación tuvo como objetivo determinar el nivel de conocimientos, actitudes y prácticas sobre salud ambiental en estudiantes ecuatorianos de la sede Huancayo de la Universidad Peruana Los Andes. La investigación fue descriptiva-transversal cuya muestra estuvo conformada por 147 estudiantes ecuatorianos matriculados en el segundo semestre 2021 de medicina y enfermería. Como instrumento se aplicó la encuesta CAP relacionadas con sostenibilidad de tres modulos y 18 ítems. Para el análisis de los datos, se calcularon proporciones y medidas de resumen, correlaciones de Spearman, prueba de Kolmogorov-Smirnov con corrección de Lilliefors. Como resultado se encontró que el nivel de conocimiento fue "Excelente" respecto conocimiento del significado de salud ambiental (x: 3,62), "Deficiente" en participación en acción de mejoramiento ambiental en la comunidad (x: 2,35) y "Malo" en participación de programas de educación ambiental (x: 1,27), así mismo, la clasificación porcentual y puntajes de las dimensiones pesquisadas fue "Deficiente" en el nivel de conocimiento (x: 52,01), "Deficiente" en actitudes (x: 53,23) y "Malo" en prácticas (x: 34,08). Es necesario implementar estrategias de abordaje integral en la formación de profesionales enfocados en el conocimiento de temas ambientales y el desarrollo de una conducta ambiental que repercutan en el mejoramiento de la salud publica(AU)

The environmental crisis is the first global crisis generated by ignorance, which is why education regarding environmental health is the starting point to replace the attitude of human relations with their environment. For this reason, this research aimed to determine the level of knowledge, attitudes, and practices on environmental health in Ecuadorian students from the Huancayo campus of the Universidad Peruana Los Andes. The research was descriptive-cross-sectional, whose sample consisted of 147 Ecuadorian students enrolled in the second semester of 2021 in medicine and nursing. As an instrument, the CAP survey related to sustainability of three modules and 18 items was applied. For data analysis, proportions and summary measures, Spearman correlations, Kolmogorov-Smirnov test with Lilliefors correction were calculated. As a result, it was found that the level of knowledge was "Excellent" regarding knowledge of the meaning of environmental health (x: 3.62), "Poor" in participation in environmental improvement action in the community (x: 2.35) and " Bad" in participation in environmental education programs (x: 1.27), likewise, the percentage classification and scores of the dimensions investigated was "Poor" in the level of knowledge (x: 52.01), "Poor" in attitudes (x: 53.23) and "Bad" in practices (x: 34.08). It is necessary to implement comprehensive approach strategies in the training of professionals focused on the knowledge of environmental issues and the development of an environmental behavior that has repercussions on the improvement of public health(AU)

Education in environmental health: scientific contributions of the last 20 years / Educación en salud ambiental: aportes científicos de los últimos 20 años

Man's attitudes about the environment have generated irreversible damage to the planet, emerging as an alternative to this problem Environmental Education, which aims to reorient social awareness towards a friendly and thoughtful culture. Through environmental education, we seek to make people aware of the problems of the natural and social environment from their school education in childhood to generate values, new attitudes, behaviors, and beliefs aimed at caring for the environment and learning new relationships between people. Likewise, to carry out these environmental education strategies, it is important to know some specific parameters, such as biological diversity and conservation, in addition to the conservation policies carried out by each nation. In this sense, in this work a bibliometric study was carried out based on high-impact scientific production and stipulated by ScienceDirect related to Environmental Education during a period of the last 20 years. The results were grouped into five clusters: "Environmental Education" OR "Education for Sustainable Development" OR "Education for Sustainability" OR "Education for Climate Change" OR "Eco citizenship". The union of all these clusters are connected and intertwined with each other. Them in a dependent way, which is a consequence of the study carried out(AU)

Las actitudes del hombre sobre el medio ambiente han generado daños irreversibles al planeta, surgiendo como alternativa para esta problemática la Educación Ambiental, que tiene como finalidad reorientar la conciencia social hacia una cultura amigable y reflexiva. Mediante la educación ambiental se busca concientizar a las personas sobre los problemas del ambiente natural y social desde su formación escolar en la niñez para generar valores, nuevas actitudes, comportamientos y creencias orientadas al cuidado del medio ambiente y el aprendizaje de nuevas relaciones entre las personas. Asimismo, para lleva a cabo estas estrategias de educación ambiental, es importante conocer algunos parámetros específicos, como la diversidad biológica y conservación, además de las políticas propias de conservación llevada a cabo por cada nación. En ese sentido, en este este trabajo se realizó un estudio bibliométrico basado en la producción científica de alto impacto y estipuladas por ScienceDirect relacionados con la Educación Ambiental durante un periodo de los últimos 20 años. Los resultados fueron agrupados en cinco clustes: "Environmental Education" OR "Education for Sustainable Development" OR "Education for Sustainability" OR "Education for Climate Change" OR "Eco citizenship". La unión de todos estos clústers se encuentran conectados y entrelados entre ellos de manera dependiente, lo cual es consecuencia del estudio realiz(AU)

Entre denunciar y aguantar. Sojización, plaguicidas y participación en salud ambiental en Uruguay / Between denouncing and enduring. Soybean expansion, pesticides and environmental health participation in Uruguay

RESUMO Desde principios de la década del 2000, se ha desarrollado una expansión de cultivo de soja transgénica en el Conosur que ha implicado un incremento exponencial de los volúmenes de plaguicidas utilizados en la región. Desde las ciencias sociales, se ha enfatizado el análisis de los conflictos socio- -ambientales para resistir ante los diversos proble-mas que conlleva este modelo productivo. Uruguay, aunque menos visible en los debates internacionales, no estuvo ajeno a dicho proceso. Este artículo tiene como objetivo introducir el caso uruguayo en el debate regional sobre los problemas ocasionados por la expansión de plaguicidas asociada al avance de la sojización y discutir las posibilidades de la participación social en salud ambiental como forma de resistencia. La metodología combina un estudio etnográfico en el núcleo agrícola del país con análisis documental. Se discuten los resultados a la luz de la antropología médica crítica, evidenciando que si bien las denuncias son mecanismos que permiten visibilizar públicamente los problemas ocasionados por el uso de plaguicidas, en el marco de las relaciones de hegemonía- -subalternidad que estructuran las relaciones sociales en una economía agraria, los alcances y límites de la participación social en salud ambiental las trascienden.

ABSTRACT Since the early 2000s, there has been an expansion of transgenic soybean cultivation in the Conosur, which has involved an exponential increase in the volumes of pesticides used in the region. Social sciences have emphasized the analysis of socio-environmental conflicts to resist the various problems that this productive model entails. Uruguay, although less visible in international debates, was not exempt from this process. This article aims to introduce the Uruguayan case in the regional debate on the problems caused by the spread of pesticides associated with the advance of soybean production and to discuss the possibilities of social participation in environmental health as a form of resistance. The methodology combines an ethnographic study in the agricultural core of the country with documentary analysis. The results are discussed in the light of critical medical anthropology, evidencing that although public complaints are mechanisms that allow public visibility of the problems caused by the use of pesticides, within the framework of hegemonysubalternity relations that structure social relations in an agrarian economy, the scope and limits of social participation in environmental health transcend them.

Conocimientos, prácticas y habilidades estudiantiles sobre la búsqueda bibliográfica e investigación en salud ambiental / Knowledge, practices and student skills on bibliographic search and research in environmental health

Durante el ejercicio profesional, los enfermeros les corresponden brindar educación a la comunidad para prevenir la exposición a los riesgos medioambientales e, integrarse y proponer profilaxis en pro del bienestar de la comunidad, en este sentido, les incumben consolidar destrezas que les permitan desarrollar historia ambiental valorando riesgos, diagnosticando problemas, proponiendo intervenciones, evaluando resultados, e incluso identificando los factores peligrosos de acuerdo a vulnerabilidades particulares. Para los estudiantes de enfermería de UNIANDES, el reto, en esta área de formación es doble (investigativa y académica), y lo deben asumir, de manera autodidáctica. Este trabajo pretendió explorar conocimientos, prácticas y habilidades estudiantiles sobre la búsqueda bibliográfica e investigación en salud ambiental. La muestra estuvo conformada por 120 estudiantes. Se precisó que 17,5% poseen conocimiento para realizar búsqueda básica de información, utilizando principalmente el motor web Google 40,8%. El nivel de destreza fue bajo 73,3%; percepción de los estudiantes, mala 49,2%: prácticas para realizar búsqueda, no sabe 54,2%, sin asociación estadísticamente significativa con sexo. Para la percepción del nivel de competencia en investigación y búsqueda de información en salud ambiental: lectura crítica obtuvo 3,08 puntos, seguida de búsqueda de información 2,98 puntos, lo que las clasifican como regular; mientras que, redacción de artículos y el proceso de publicación, ambas con 2,70 puntos; se catalogan deficientes. Estos resultados permiten afirmar que es necesario un acompañamiento permanente en la instrucción sobre el uso de información digital a lo largo de la carrera y con especial atención en el área de salud ambiental(AU)

During professional practice, nurses are responsible for providing education to the community to prevent exposure to environmental risks and integrate and propose prophylaxis for the well-being of the community, in this sense, they are responsible for consolidating skills that allow them to develop environmental history assessing risks, diagnosing problems, proposing interventions, evaluating results, and even identifying dangerous factors according to particular vulnerabilities. For UNIANDES nursing students, the challenge in this training area is twofold (investigative and academic), and they must assume it in a self-taught manner. This work aimed to explore student knowledge, practices and skills on bibliographic search and research in environmental health. The sample consisted of 120 students. It was specified that 17.5% have knowledge to perform basic information searches, mainly using Google web engine 40.8%. The skill level was low 73.3%; perception of the students, poor 49.2%: practices to carry out searches, do not know 54.2%, without statistically significant association with gender. For the perception of the level of competence in research and information search in environmental health: critical reading obtained 3.08 points, followed by information search 2.98 points, which classifies them as regular; while, writing articles and the publication process, both with 2.70 points; are classified as deficient. These results allow us to affirm that permanent accompaniment is necessary in the instruction on the use of digital information throughout the career and with special attention in the area of environmental health(AU)

El compostaje de cáscara de Musa paradisiaca L. para la producción de biogás y biometano como estrategia de preservación de la salud ambiental / Musa paradisiaca L. husk composting for biogas and biomethane production as a strategy for preserving environmental health

A medida que a se avanza en el siglo XXI, los sistemas de energía deben alejarse de los combustibles fósiles y aumentar la capacidad de las energías renovables si se quieren cumplir los objetivos de temperaturas máximas del Acuerdo de París. Sin embargo, debido a los desafíos en la adopción de tecnologías bajas en carbono, ciertas áreas de los sistemas energéticos globales son difíciles de controlar y descarburar. Por otra parte, el compostaje es una de las prácticas de gestión de residuos orgánicos más importantes que se puede utilizar para lograr la sostenibilidad del suelo y del medio ambiente. El compost tiene un mínimo impacto en algunas emisiones, y puede ayudar a controlar la huella de carbono y limitar los efectos ambientales negativos de los métodos de eliminación de desechos más deficientes. La investigación tuvo por objetivo determinar la calidad de producir biogás y biometano a partir de la cáscara de plátano (Musa paradisiaca L.). Metodológicamente se desarrolló una investigación aplicada, con nivel de investigación de tipo experimental. Las cáscaras de plátano se colectaron de la planta de compostaje de la Municipalidad Provincial de Leoncio Prado, Perú. De la muestra se prepararon cinco sub muestras para la producción de biogás y cinco muestras adicionales para la producción de biometano. Los sistemas mostraron una producción de 0,067 m3 BG/Kg ST de biogás y 0,059 m3CH4/Kg ST de biometano, que generó subproductos como el biol y biosol. Estos resultados presentaron una baja toxicidad al ser sometidos a pruebas germinativas, concluyéndose que solo el 11,5% de la cáscara introducida al biorreactor se degrado y de esta fracción solo el 2,8% se convirtió en biogás(AU)

As progress is being made in the 21st century, energy systems must move away from fossil fuels and increase the capacity of renewable energies if you want to meet the maximum temperatures objectives of the Paris Agreement. However, due to the challenges in the adoption of low carbon technologies, certain areas of global energy systems are difficult to control and decarbure. On the other hand, composting is one of the most important organic waste management practices that can be used to achieve soil and environmental sustainability. The compost has a minimum impact on some emissions, and can help control the carbon footprint and limit the negative environmental effects of the most deficient waste removal methods. The research aimed to determine the quality of producing biogas and biomethane from the banana peel (Musa paradisiaca L.). Methodologically, an applied investigation was developed, with experimental research level. The banana peels were collected from the composting plant of the Provincial Municipality of Leoncio Prado, Peru. From the sample, five sub samples were prepared for the production of biogas and five additional samples for biomethane production. The systems showed a production of 0.067 m3 bg/kg ST of biogas and 0.059 m3ch4/kg ST of biomethane, which generated by -products such as biol and biosol. These results presented a low toxicity when they were subjected to germinative evidence, concluding that only 11.5% of the shell introduced into the bioreactor was degraded and of this fraction only 2.8% became biogas(AU)

Conflicto armado, contaminación y riesgos en salud: una evaluación de riesgo de tres fuentes de exposición ambiental asociadas con el conflicto en Colombia / Armed conflict, pollution, and health risks: A risk evaluation of three sources of environmental exposure associated with the conflict in Colombia

Resumen | Introducción. Los conflictos armados afectan los territorios ricos en recursos y biodiversidad; el daño ambiental causado por las acciones violentas puede afectar la salud de las poblaciones. Objetivos. Evaluar los riesgos para la salud humana debidos a la degradación ambiental asociada con tres acciones violentas en el marco del conflicto armado colombiano: la voladura de oleoductos, la minería informal con mercurio y la aspersión de cultivos ilícitos con glifosato. Materiales y métodos. Se hizo una evaluación cuantitativa de los riesgos para la salud individual asociados con actividades del conflicto armado, usando metodologías que tienen en cuenta la ruta de dispersión de los contaminantes, su concentración en el ambiente, la exposición de los individuos y los riesgos de efectos cancerígenos y no cancerígenos. Resultados. La evaluación de los riesgos asociados con las acciones en el marco del conflicto armado analizadas, evidenció un riesgo cancerígeno intolerable y uno no cancerígeno inaceptable debidos al consumo de agua y peces contaminados por hidrocarburos aromáticos policíclicos, mercurio y glifosato. Conclusiones. El estudio reafirmó las conexiones inextricables que existen entre ambiente, sociedad y salud, y las implicaciones de la violencia ambiental para la salud pública de los grupos poblacionales vulnerables y, en general, para el bienestar de todos los seres vivos afectados por el conflicto armado.

Abstract | Introduction: Armed conflicts affect territories rich in resources and biodiversity. As a result of the environmental damage caused by violent actions, the health of populations can be affected. Objectives: To assess the risks to human health due to environmental degradation associated with three violent actions in the context of the Colombian armed conflict: Pipeline bombing, informal mining with mercury, and spraying of illicit crops with glyphosate. Materials and methods: We conducted a quantitative evaluation of the risks to individual health associated with armed conflict activities using methodologies focused on the routes of pollutants dispersion, their concentrations in the environment, the exposure of the individuals, and the risks of carcinogenic and non-carcinogenic effects. Results: The risk assessment of the armed conflict-related actions under study evidenced intolerable carcinogenic risk and unacceptable non-carcinogenic risk due to the consumption of water and fish contaminated by polycyclic aromatic hydrocarbons (PAH), mercury, and glyphosate. Conclusions: The study reiterates the inextricable connections existing among the environment, society, and health, as well as the implications of environmental violence for the public health of vulnerable population groups and, in general, for the well-being of all living beings affected by the armed conflict.

Dimensión ambiental en la formación de profesionales de la salud: concepciones de los docentes de una universidad pública

Objetivo. Analizar las concepciones de docentes sobre la integración de la dimensión ambiental en la formación de profesionales de salud en una universidad pública. Métodos. Estudio cualitativo, donde participaron 13 docentes seleccionados por un muestreo socioestructural. Se aplicó una entrevista semiestructurada y la técnica de análisis de contenido utilizando ATLAS.ti. Resultados. Los docentes reconocieron limitaciones para incorporar la dimensión ambiental en profesionales de la salud, pero se concentran en los cambios que se necesitarían para su integración a nivel macro y microcurricular. El análisis evidencia la vinculación entre los cambios necesarios con acciones de sensibilización y socialización, gestión política y administrativa, y propuestas de mejora de infraestructura. Conclusión. Los docentes, a pesar de las limitaciones, tienen concepciones proactivas hacia el cambio, lo que favorecería su participación en procesos de reforma curricular hacia una formación orientada al desarrollo sostenible.

Objective. Analyze the conceptions of teachers about the integration of the environmental dimension in the training of health professionals in a public university. Methods. Qualitative study, where 13 teachers selected by a socio-structural sampling participated. A semi-structured interview and the content analysis technique were applied using ATLAS.ti. Results. The teachers recognized limitations to incorporate the environmental dimension in health professionals, but they focus on the changes that would be needed for its integration at the macro and micro-curricular level. The analysis shows the link between the necessary changes with awareness and socialization actions, political and administrative management, and proposals for infrastructure improvement. Conclusion. Teachers, despite the limitations, have proactive conceptions towards change, which would favor their participation in curricular reform processes towards training oriented towards sustainable development.

Estratégia Saúde da Família e Vigilância em Saúde: conhecimento de médicos de família e comunidade sobre Vigilância Sanitária, Vigilância em Saúde Ambiental e Vigilância em Saúde do Trabalhador / Family Health Strategy and Health Surveillance: knowledge of community and family physicians on Sanitary Surveillance, Environmental Health Surveillance and Surveillance of the Workers Health / Estrategia de Salud Familiar y Vigilancia en Salud: conocimiento de los médicos de familia y comunitarios en Vigilancia Sanitaria, Vigilancia em Salud Ambiental y Vigilancia de la Salud del Trabajador

Introdução: A interação entre os setores do Sistema Único de Saúde, particularmente a Atenção Básica (AB) e a Vigilância em Saúde (VS), é essencial para que ações com foco na integralidade sejam operacionalizadas nos serviços. Para isso, é necessário, além de outros fatores, o conhecimento mútuo entre as áreas, sobre seus escopos de atuação. Objetivo: analisar o conhecimento de médicos de equipes da Estratégia de Saúde da Família sobre Vigilância em Saúde Ambiental (VIGIAM), Vigilância Sanitária (VISA) e Vigilância em Saúde do Trabalhador (VISAT). Métodos: Estudo com abordagem qualitativa, realizado com oito médicos de equipes saúde da família de municípios do interior de Minas Gerais. Empregou-se a técnica de grupo focal conduzida com uso de situação-problema. A análise de conteúdo temática guiou o tratamento dos dados. Resultados: A VIGIAM e a VISAT foram as vigilâncias com menor familiaridade entre os médicos, sendo associadas superficialmente ao controle de fatores ambientais e à fiscalização do trabalho, respectivamente. A VISA foi associada à fiscalização de produtos. Maior integração das equipes com os agentes de controle de endemias e capacitação em VS foram propostas para a melhoria da integração. Ações intersetoriais foram sugeridas, principalmente quando relacionadas à VISAT. Conclusões: Diante da baixa familiaridade sobre VS, a educação permanente constitui estratégia fundamental para a integração da AB e VS. Considerando que as ações destes setores são descentralizadas, espera-se maior protagonismo e proatividade dos gestores locais para que ocorra a devida capilaridade da VS na principal porta de entrada do sistema público de saúde brasileiro

Introduction: The interaction between the sectors of the Unified Health System, particularly Primary Health Care (PHC) and Health Surveillance (HS), is essential for actions that focus on integrality to be operationalized in services. For this, it is necessary, in addition to other factors, mutual knowledge between the areas, about their scope of action. Objective: The aim of the study was to analyze the knowledge of physicians from the Family Health Strategy teams on Environmental Health Surveillance (EHS), Sanitary Surveillance (SS) and Surveillance of the Workers Health (SWH). Methods: Study with a qualitative approach, conducted with eight physicians from family health teams in cities in the interior of Minas Gerais. The focus group technique was used using a problem-situation. Thematic content analysis guided the treatment of the data. Results: EHS and SWH were the surveillances with less familiarity among physicians, being superficially associated with the control of environmental factors and labor inspection, respectively. SS was associated to product inspection. Greater integration of the teams with agents of endemic control and training in Health HS were proposed to improve integration. Intersectoral actions were suggested, especially when related to SWH. Conclusions: In view of the low familiarity with HS, permanent education is a fundamental strategy for the integration of PHC and HS. Considering that the actions of these sectors are decentralized, greater protagonism and proactivity is expected from local managers in order to reach the proper capillarity of HS at the main gateway to the Brazilian public health system.

ESF e Vigilância em SaúdeRev Bras Med Fam Comunidade. Rio de Janeiro, 2021 Jan-Dez; 16(43):27332Introdução Um importante pilar na saúde pública brasileira é a Vigilância em Saúde (VS), cujas primeiras medidas remontam desde o período colonial, mas que teve sua sistematização apenas no século XX1, 2. A VS tem como função principal buscar soluções para os problemas ocorrentes no âmbito da saúde, a partir de uma estratégia flexível para cada situação e população, além de ser responsável pelo controle de doenças transmissíveis e não transmissíveis, prevenção de doenças e fatores de risco, formulando uma análise mais completa da situação geral de saúde da população3.Em 12 de julho de 2018, foi instituída a Política Nacional de Vigilância em Saúde (PNVS), por meio da Resolução no 588/2018 do Conselho Nacional de Saúde (CNS)4. Na PNVS, a Vigilância em Saúde é entendida como processo contínuo e sistemático de coleta, consolidação, análise de dados e disseminação de informações sobre eventos relacionados à saúde, visando o planejamento e a implementação de medidas de saúde pública, incluindo a regulação, intervenção e atuação em condicionantes e determinantes da saúde, para a proteção e promoção da saúde da população, prevenção e controle de riscos, agravos e doenças4.Ademais, a VS se divide em áreas específicas, com atribuições particulares e interligadas entre si, quais sejam: Vigilância em Saúde Ambiental (VIGIAM), Vigilância em Saúde do Trabalhador (VISAT), Vigilância Epidemiológica (VIGEP), Vigilância Sanitária (VISA), além da análise de situação de saúde, promoção da saúde e ações laboratoriais que são atividades transversais e essenciais no processo de trabalho da VS4. Introducción: La interacción entre los sectores del Sistema Único de Salud, en particular la Atención Primaria (AP) y la Vigilancia en Salud (VS), es fundamental para que las acciones que se enfocan en la integralidad sean operacionales en los servicios. Para ello, es necesario, además de otros factores, el conocimiento mutuo entre las áreas, sobre su ámbito de actuación. Objetivo: analizar el conocimiento de los médicos de los equipos de la Estrategia de Salud Familiar en Vigilancia en Salud Ambiental (VSA), Vigilancia Sanitaria (VISA) y Vigilancia de la Salud del Trabajador (VISAT). Métodos: Estudio con abordaje cualitativo, realizado con ocho médicos de equipos de salud de la familia en ciudades del interior de Minas Gerais. Se utilizó la técnica de grupo focal, utilizando situaciones problemáticas. El análisis de contenido temático guió el tratamiento de los datos. Resultados: VSA y VISAT fueron las vigilancias menos familiarizadas entre los médicos, asociándose superficialmente con el control de factores ambientales y la inspección del trabajo, respectivamente. VISA se asoció con la inspección de productos. Se propuso una mayor integración de equipos con agentes de control de enfermedades endémicas y formación en VS para mejorar la integración. Se sugirieron acciones intersectoriales, especialmente en lo relacionado con VISAT. Conclusiones: Ante la baja familiaridad con la VS, la educación permanente es una estrategia fundamental para la integración de AP y VS. Considerando que las acciones de estos sectores son descentralizadas, se espera más protagonismo y proactividad de los gestores locales para que la capilaridad adecuada de la VS se produzca en la principal puerta de entrada al sistema público de salud brasileño.

Leishmania Game: tecnologia educativa para prevenção/ensino de leishmaniose visceral / Leishmania Game: educational technology for prevention/teaching visceral leishmaniasis

Introdução: a leishmaniose visceral, mais conhecida como calazar, é uma doença crônica causada por protozoários de Leishmania infantum e é uma doença caracterizada como endêmica no município de Pau dos Ferros, estado do Rio Grande do Norte. Dessa forma, a construção de uma tecnologia educativa pode ser uma ferramenta auxiliadora no processo de ensino e aprendizagem dos alunos. Objetivo: construir e validar conteúdo e aparência de jogo didático no ensino de leishmaniose visceral para alunos do ensino fundamental. Metodologia: trata-se de um estudo metodológico de abordagem quantitativa. O jogo foi confeccionado a partir de um esboço feito à mão pela autora e posteriormente entregue a um profissional responsável pelo design. Para validar o jogo, foi aplicado um protocolo de validação para 10 juízes que validaram o jogo de acordo com as expectativas curriculares e cognitivas dos alunos dos anos finais do ensino fundamental. Os dados coletados foram organizados no Microsoft® Excel® e posteriormente apresentados em gráficos e tabelas para análise final. Resultados: no que diz respeito à média geral da tecnologia educacional, obteve-se média 4,6, que corresponde a 92% de concordância dos juízes. Dessa maneira, comprova-se que todos os itens da tecnologia educacional "Leishmania" foram validados pelos juízes obtendo média superior ao estipulado. Conclusão: todos os itens apresentados no protocolo de validação foram considerados adequados na avaliação dos juízes, o que garante a confiabilidade do instrumento para ser utilizado. Dessa forma, o jogo pode ser utilizado com segurança por professores para avaliar o conhecimento dos alunos acerca da leishmaniose visceral.(AU)

Introduction: visceral leishmaniasis, better known as calazar, is a chronic disease caused by protozoa of Leishmania infantum and is a disease characterized as endemic in the municipality of Pau dos Ferros, state of Rio Grande do Norte. Thus, the construction of an educational technology can be a helping tool in the teaching and learning process of students. Objective: to construct and validate content and appearance of didactic game in the teaching of visceral leishmaniasis for elementary school students. Methodology: this was a methodological study with a quantitative approach. The game was handmade from a sketch by the author and delivered to a professional responsible for the design. To validate the game, an authentication protocol was applied to 10 judges who validated the game according to the curricular and cognitive expectations of students in the final years of elementary school. The collected data were organized in MicrosoftTM ExcelTM and later presented in graphs and tables for final analysis. Results: regarding the overall average of educational technology, obtained a score of 4.6, corresponding to 92% of the judges' agreement. Thus, it is proven that all items of educational technology "Leishmania" were validated by the judges obtaining an average higher than stipulated. Conclusion: all items presented in the validation protocol were considered adequate in the evaluation of the judges, which guarantees the reliability of the instrument to be used. Thus, the game can be safely used by teachers to assess students' knowledge about visceral leishmaniasis.(AU)

Competences in health promotion in the environmental education practices of community health agents / Competencias en la promoción de la salud en las prácticas de educación ambiental de los agentes de salud comunitários / Competências em promoção da saúde nas práticas de educação ambiental de agentes comunitários de saúde

ABSTRACT Objective: To recognize the domains of competencies in promoting health in the environmental education practices performed by community health agents. Method: A mixed study, which adopted the Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) as a theoretical framework, conducted in Crato, Ceará, with 16 community health agents, based on semi-structured interviews and data organization through the ALCESTE software. Results: The following domains of competencies in health promotion were evidenced: partnership, possibility of changes, and diagnosis. We recognize evidence signaling other domains, although with less statistical significance, such as: communication, planning and implementation, with a view to developing environmental education activities. Final considerations: There is a mobilization of a limited number of health promotion competences in the environmental education practices developed by community health agents, which requires the wholeness of these elements to implement health promotion practices and, thus, positive transformations on the environment and health.

RESUMEN Objetivo: Reconocer los dominios de competencias en promoción de la salud en las prácticas de educación ambiental llevadas a cabo por agentes comunitarios de salud. Método: Un estudio mixto, que adoptó el Developing Competencies and Profissional Standards for Health Promotion Capacity Building in Europe(CompHP) como referencia teórica, realizado en Crato, Ceará, con 16 agentes de salud comunitarios, basado en entrevistas semiestructuradas y organización de datos utilizando el software ALCESTE. Resultados: Se destacaron los siguientes dominios de competencias en la promoción de la salud: asociación, posibilidad de cambios y diagnóstico. Se reconoce evidencia que apunta a otros dominios, aunque con menos significancia estadística, tales como: comunicación, planificación e implementación, para el desarrollo de actividades de educación ambiental. Consideraciones finales: Se registra una movilización de una cantidad limitada de competencias de promoción de la salud en las prácticas de educación ambiental desarrolladas por agentes de salud comunitarios, todo lo cual es necesario para implementar prácticas de promoción de la salud y, por lo tanto, transformaciones positivas sobre el medio ambiente y la salud.

RESUMO Objetivo: Reconhecer domínios de competências em promoção da saúde nas práticas de educação ambiental realizadas pelos agentes comunitários de saúde. Método: Estudo misto, que adotou como referencial teórico o Developing Competencies and Profissional Standards for Health Promotion Capacity Building in Europe (CompHP), realizado em Crato, Ceará, junto a 16 agentes comunitários de saúde, a partir de entrevista semiestruturada e organização dos dados através do software ALCESTE. Resultados: Foram evidenciados os domínios de competências em promoção da saúde de parceria, possibilidade de mudanças e diagnóstico. Reconhecem-se evidências que apontam outros domínios, embora com menor significância estatística, tais como: comunicação, planejamento e implementação, para o desenvolvimento das atividades de educação ambiental. Considerações finais: Há a mobilização de um número limitado de domínios de competências em promoção da saúde nas práticas de educação ambiental desenvolvidas pelos agentes comunitários de saúde, sendo necessária a totalidade destes para concretizar as práticas de promoção da saúde.

Estrategia de educación universitaria virtual en salud ambiental para el desconfinamiento: caso Ecuador / Virtual university education strategy in environmental health for deconfinement: case of Ecuador

La Salud Ambiental cobra un papel relevante en el marco de la pandemia por COVID-19 debido a las diferentes actividades que deben desarrollarse desde su enfoque para la prevención y control de la transmisión del virus, resultando útil para su contención y el desconfinamiento progresivo de la población. En tal sentido, es necesaria la formación educativa en el área, y considerando las restricciones y limitaciones de acceso, se propone la creación de un curso virtual básico acerca de las medidas establecidas en los distintos protocolos emitidos en el Ecuador desde la Universidad Laica Eloy Alfaro de Manabí. La propuesta está constituida por seis (6) módulos: Definiciones pertinentes, Líneas de acción básicas, Acciones personales, Limpieza y desinfección de espacios, Agua potable y sistema integral de saneamiento, y Vigilancia ambiental de espacios recreativos. Los contenidos se dictarán completamente a distancia, ambientadas en la plataforma digital Moodle, disponiendo de recursos didácticos y diferentes estrategias de evaluación con la finalidad de construir conocimiento(AU)

Environmental Health takes on a relevant role in the framework of the COVID-19 pandemic due to the different activities that must be developed from its approach to the prevention and control of the virus transmission, being useful for its containment and the progressive population deconfinement. In this sense, educational training in the area is necessary, and considering the restrictions and limitations to access, it was established the creation of a basic virtual course on the actions of the different protocols issued in Ecuador from Universidad Laica Eloy Alfaro de Manabí, The proposal is made up of six (6) completely remote modules: Relevant definitions, Basic lines of action, Personal actions, Cleaning and disinfection of spaces, Drinking water and comprehensive sanitation system, and Environmental surveillance of recreational spaces. The contents will be taught completely remotely, set on the Moodle digital platform, with didactic resources and different evaluation strategies in order to build knowledge(AU)