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For many women, house cleaning is an important way to participate in the labor market. In Brazil, there are 2 types of domestic workers: housekeepers have relatively secure employment and house cleaners are day laborers. The aim of this hypothesis-generating study was to describe the sociodemographic, occupational and health profile of a sample of domestic workers in Brazil. House cleaners received lower wages, had longer daily working hours and worked in a larger number of homes each week in comparison to housekeepers. About 51% of the domestic workers in this sample reported the use of pain medication and 34% reported spinal problems. Musculoskeletal symptoms were frequent in the lower back and upper limbs. Forty-seven percent reported high blood pressure. This study highlights the vulnerability of domestic workers, especially house cleaners, regarding workload, salary, and health conditions. Level of education is a contributing factor to this vulnerability.

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For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors (family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.

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BACKGROUND: Adolescents with type 1 diabetes (T1D) are at increased risk for depression. A history of recurrent depression (HRD) may relate to worse health outcomes than single-episode depression. However, no study has explored this issue among T1D adolescents. PARTICIPANTS AND PROCEDURE: We examined differences in psychosocial and diabetes-related outcomes between T1D adolescents with (G1; n = 33) and without (G2; n = 18) HRD. Participants were 51 youths (aged 12-17 years) enrolled in a depression treatment study. Youths and one caregiver each completed several measures. Using MANOVA, followed by individual ANOVAs, and chi-square tests, we compared groups in continuous and categorical variables, respectively. RESULTS: MANOVA results were significant, F(7, 43) = 3.97, p = .002. Adolescents from G1 obtained higher scores than youths in G2 in self-esteem/guilt problems, cognitive alterations, and sadness due to T1D. Their caregivers reported more burden and rated their offspring as having more internalizing problems, facing more barriers to complying with T1D treatment, and using a medical ID less frequently than their counterparts did. A higher percentage of G1 participants presented clinical anxiety and inadequate glycemic control, and reported a history of major depression. According to caregivers, a higher proportion of G1 members had experienced multiple diabetes-related hospitalizations, were non-compliant with insulin treatment, and lived in homes with a conflictive environment. CONCLUSIONS: Our study documents important differences in outcomes between T1D youths with vs. without any HRD. Clinicians may need an intensive and integrative approach to treat mental and physical aspects of health among these patients.

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BACKGROUND: Various factors, including mental health comorbidity, family dysfunction, interpersonal violence, and community and social violence, cause suicidal behavior. Adverse Childhood Experiences (ACEs) encompass these risk factors and are correlated with mental health problems and suicidal behavior in Mexican adolescents. METHODS: A survey was conducted among Mexican school-aged adolescents to measure ACEs, MHP symptoms, and suicidal behavior. A binary logistic regression was used to examine the relationship between these variables. The study was conducted with IRB approval, and all participants provided informed consent. Those at risk of suicide were referred for online psychological care. RESULTS: 7325 adolescents participated; 60 % were women, with an average age of 16 years (SD + 1), 87 % of the participants reported at least one ACE, 13 % symptoms of at least one MHP and 10 % suicidal behavior. MHP predictors of suicidal behavior were: conduct problems (OR = 5.67), symptoms of depression (OR = 3.27), obsessive-compulsive disorder (OR = 2.11), somatic problems (OR = 1.98), and attention deficit (OR = 1.69). EAI predictors were: live sexual violence (OR = 2.53), physical violence (OR = 2.21), negligence (OR = 2.05), bullying (OR = 2.10), and a family member with a mental health diagnosis (OR = 1.35). The cumulative effect of ACEs and MHP significantly increased the risk (OR = 78.08). CONCLUSIONS: 5 ACEs and 4 MHP were associated with suicidal behavior; their cumulative effect increased the risk to 78 times.

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(1) Background: loneliness is a problem that becomes increasingly acute in old age, with greater repercussions among socially disadvantaged groups such as indigenous and Afro-descendant older adults. The aim of this research is to analyze the psychosocial variables related to loneliness in old age. (2) Methods: a multi-ethnic sample was involved, with the participation of eight indigenous peoples and Afro-descendant tribal people (n = 1.348). Various gerontological scales previously validated among the Chilean population (De Jong Gierveld Loneliness Scale, Brief Resilient Coping Scale, Health Problems Questionnaire, and Family APGAR questionnaire) and a model are contrasted, establishing the relationship between psychosocial variables and loneliness. (3) Results: Structural equation modeling (SEM) showed the existence of indirect relationships between health problems, via family functioning and resilience, and loneliness. Resilience and family functioning were directly related to loneliness (WLSMV-χ2 (df = 345) = 875.106, p < 0.001; CFI = 0.992; TLI = 0.991; RMSEA = 0.034 [C.I. 90% = 0.031-0.037]). (4) Conclusions: loneliness has cross-culturally affected older Chilean people living in rural areas and it appears that the COVID-19 pandemic has had a negative effect on well-being. This study proves that loneliness is related to several psychosocial variables that can be intervened.

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Very little is known in Haiti and the Caribbean regarding child and lifetime sexual victimization. Using a nationally representative sample of adolescents and young adults aged 15-24, this study aimed to document the prevalence, risk factors and mental health correlates of lifetime and child sexual violence in Haiti. A national cross-sectional surrvey was conducted in Haiti, using a multistage sampling frame, stratified by geographical department, urban or rural setting, gender, and age groups (15-19 and 20-24 years). The final sample included 3586 household participants (47.6% female). A weighted sample of 3945 individuals was obtained and used in the following analyses. Overall rate of lifetime and child sexual violence was, respectively, 27.44% (95% CI 25.94-28.94) and 11.27% (95% CI 10.18-12.35). Lifetime sexual violence rate was significantly higher among female participants (29.02%; 95% CI 27.5-30.55) compared to male (25.73%, 95% CI 24.26-27.2), χ2 = 4.63, p < .05, but there was no significant gender difference for child sexual victimization. Experiences of family physical violence, emotional abuse by mother and father, divorce of parents, and other physical violence were strongly associated with higher odds of sexual victimization. Participants who reported having experienced sexual violence are more at risk to meet criteria of PTSD (OR = 1.96, 95% CI 1.66-2.32; p < .0001), depression (OR = 1.73, 95% CI 1.47-2.02; p < .0001), psychological distress (OR =1.72, 95% CI 1.47-2.02; p < .0001), and substance abuse (OR = 1.33, 95% CI 1.13-1.57; p < .0001). Findings demonstrate that sexual violence is a public health emergency in Haiti. They provide evidence for the development of prevention and intervention programs.

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RESUMO A 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde representa um avanço no enfoque do conhecimento e em novas abordagens das doenças. A Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde é utilizada para diferentes finalidades práticas, possibilitando avaliação do avanço da agenda de saúde global, alocação de recursos, segurança do paciente, qualificação da assistência à saúde e reembolso de seguros de saúde. É inteiramente digital, com recursos tecnológicos que permitem sua atualização periódica. No início de 2022, a 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde entrou em vigência oficial, tendo sido disponibilizada em vários de seus idiomas oficiais, como o árabe, chinês, espanhol, francês e inglês. Apresenta-se aqui o processo de tradução para a língua portuguesa em uso no Brasil, coordenado pela Universidade Federal de Minas Gerais, com apoio do Ministério da Saúde do Brasil e da Organização Pan-Americana da Saúde/Organização Mundial da Saúde. O trabalho foi realizado em três etapas entre agosto de 2021 e dezembro de 2022 por tradutores com diferentes formações: médicos especialistas (49), fisioterapeuta (1), farmacologista (1) e odontologista (1). Com este artigo metodológico, almeja-se ampliar a discussão de perspectivas para implementação da 11a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde no Brasil e construir uma oportunidade para sua adaptação e uso por outros países de língua oficial portuguesa.

ABSTRACT The 11th International Statistical Classification of Diseases and Related Health Problems (ICD-11) represents an advance in the focus on knowledge and new disease approaches. The ICD is used for different practical purposes, enabling assessment of progress in the global health agenda, resource allocation, patient safety, health care qualification, and health insurance reimbursement. It is entirely digital, with technological resources that allow periodic updating. In early 2022, ICD-11 entered into official force, having been made available in several official ICD languages such as Arabic, Chinese, Spanish, French, and English. The translation process into Brazilian Portuguese, coordinated by the Federal University of Minas Gerais (UFMG), with support from the Brazilian Ministry of Health (MS) and PAHO/WHO, is presented here. The work was carried out in three stages between August 2021 and December 2022 by translators with different backgrounds: medical specialists (49), physiotherapists (1), pharmacologists (1), and dentists (1). This methodological article aims to broaden the discussion of perspectives on implementing the ICD-11 in Brazil and build an opportunity for its adaptation and use by other Portuguese-speaking countries.

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Chelates are nutrient-rich compounds that enhance the condition of plant tissues as micronutrients. Micronutrient deficiencies particularly iron (Fe) and zinc (Zn) leads to various problems for plant including chlorosis and necrosis etc. An adequate intake of Fe and Zn etc. is required by the human body. Biofortification of cereals with Fe and Zn is seen as a cost-effective solution to the problem of Fe and Zn deficiencies as well. In recent decades, many chelating compounds have been established and incorporated into agricultural systems. The most recent formulation involves the use of amino acids synthesized with one or more nutrient ions to improve fertilizer efficiency and better respond to environmental conservation. In addition to its primary function as a source of micronutrients, aminochelled are an active nitrogen (N) stimulant in plant nutrition, preventing the negative effects of basic N fertilizers like urea. The use of amino chelates, rather than just chemical fertilizers, has been shown to provide better production and quality as well as higher nutritional concentrations in several experiments. Furthermore, this review sheds light on various aspects of amino chelates fertilizers including types, history, and their effects on agricultural crops. In spite of amino chelates fast dominance in many countries' fertilizer countries, there is not enough scientific data and knowledge on the specific reactions of plants to biotic and abiotic stresses from amino fertilizers.

Os quelatos são compostos ricos em nutrientes que melhoram a condição dos tecidos vegetais como micronutrientes. Deficiências de micronutrientes, particularmente ferro (Fe) e zinco (Zn), levam a vários problemas para as plantas, incluindo clorose e necrose, etc. A ingestão de uma quantidade adequada de Fe e Zn, etc., é exigida pelo corpo humano. A biofortificação de cereais com Fe e Zn também é vista como uma solução econômica para o problema das deficiências de Fe e Zn. Nas últimas décadas, muitos compostos quelantes foram estabelecidos e incorporados em sistemas agrícolas. A formulação mais recente envolve o uso de aminoácidos sintetizados com um ou mais íons nutrientes para melhorar a eficiência do fertilizante e responder melhor à conservação ambiental. Além de sua função primária como fonte de micronutrientes, os aminoquelados são um estimulante de nitrogênio (N) ativo na nutrição das plantas, evitando os efeitos negativos de fertilizantes nitrogenados básicos como a ureia. O uso de aminoquelatos, ao invés de apenas fertilizantes químicos, tem mostrado proporcionar melhor produção e qualidade, bem como maiores concentrações nutricionais em vários experimentos. Além disso, a presente revisão lança luz sobre vários aspectos dos fertilizantes aminoquelatos, incluindo tipos, história e seus efeitos nas culturas agrícolas. Apesar do domínio rápido dos aminoquelatos em muitos países de fertilizantes, não há dados científicos suficientes e conhecimento sobre as reações específicas das plantas aos estresses bióticos e abióticos dos fertilizantes amino.

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Introducción: Las infecciones asociadas con la asistencia sanitaria representan un grave problema de salud e impacto económico, elementos que conducen a un aumento en el número de días estancia, agrava el pronóstico del paciente grave y condiciona costo familiar y social. Objetivo: Determinar los principales factores de riesgo asociados a las infecciones relacionadas con la atención médica en la unidad de cuidados intensivos. Métodos: Estudio observacional, analítico, tipo casos y controles en la sala de cuidados intensivos del Hospital Pediátrico Universitario "Paquito González Cueto" en pacientes con infecciones relacionadas con los servicios sanitarios, desde enero 2018 a diciembre 2020. Resultados: Predominaron los menores de 4 años fundamentalmente el grupo de 1-4 años con riesgo 2,1 veces mayor para las infecciones con ligero predominio del sexo masculino, prevalecieron los normopesos 31,6 % que presentaron algún déficit nutricional por defecto, con un riesgo de infección de 7,2 veces para desnutridos; 48,3 % de los pacientes tenían un factor intrínseco asociado. Las enfermedades neurológicas crónicas, oncoproliferativas e inmunodeficiencias fueron las más representativas; el uso previo de antibióticos, cateterismo y estadía hospitalaria prolongada fueron los factores extrínsecos que predominaron, con riesgo significativo en casi la totalidad de los pacientes. Conclusiones: Existe asociación con riesgo elevado de infección en niños menores de 4 años, con déficit nutricional por defecto; factores intrínsecos como las enfermedades crónicas con predominio de las neurológicas y factores de riesgo extrínsecos significativos en su mayoría. Esto permite dirigir las estrategias de mejora para disminuir la morbilidad y mortalidad.

Introduction: Infections associated with healthcare represent a serious health problem and an economic impact, elements that lead to an increase in the number of days/stay, worsen the prognosis of the seriously ill patient and conditions family and social cost. Objective: To determine the main risk factors associated with healthcare-related infections in the intensive care unit. Methods: Observational, analytical, case-control type study in the intensive care unit of "Paquito González Cueto" University Pediatric Hospital in patients with infections related to health services, from January 2018 to December 2020. Results: Children under 4 years of age predominated, mainly the group of 1-4 years with a 2.1 times higher risk for infections, with a slight predominance of the male sex, the normal weight prevailed (31.6%) who presented some nutritional deficit by default, with a risk of infection of 7.2 times for malnourished; 48.3% of the patients had an associated intrinsic factor. Chronic neurological, onco-proliferative and immunodeficiencies diseases were the most representative; the previous use of antibiotics, catheterization and prolonged hospital stay were the extrinsic factors that predominated, with significant risk in almost all patients. Conclusions: There is an association with an elevated risk of infection in children under 4 years of age, with nutritional deficit by default; intrinsic factors such as chronic diseases with a predominance of neurological diseases and significant extrinsic risk factors. This makes it possible to direct improvement strategies to reduce morbidity and mortality.

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RESUMEN Aprender solucionando problemas constituye una estrategia educacional de elección cuando se persiguen la integración y contextualización curriculares, para formar un médico que deberá ser un comunicador, capaz de trabajar en equipos y de educar al individuo y a la comunidad a vivir con salud. A las Ciencias Básicas Biomédicas se le reconoce su contribución al desarrollo del pensamiento científico de los estudiantes, además de la aportación de contenidos esenciales que constituyen las bases biológicas de la profesión, que sirven de punto de partida para la ampliación, actualización y aplicación de los contenidos en el aprendizaje del método clínico-epidemiológico y para la autoeducación en este campo a lo largo de su vida profesional. Mediante la relación de los contenidos de esta disciplina con los problemas de salud, se fortalece el compromiso académico, el aprendizaje autodirigido, significativo y activo, así como el rendimiento académico, la motivación y la participación, lo que ofrece satisfacción y bienestar al estudiante en un contexto en el que las enfermedades crónicas no trasmisibles constituyen uno de los mayores retos que enfrentan los sistemas de salud a nivel mundial.

ABSTRACT Learning by solving problems constitutes an educational strategy of choice when curricular integration and contextualization are pursued, to train a doctor who must be a communicator, capable of working in teams and educating the individual and the community to live with health. Basic Biomedical Sciences are credited with their contribution to the development of students' scientific thinking, in addition to providing them with essential content that constitutes the biological bases of the profession and that serves as a starting point for the expansion, updating and application of the contents in learning the clinical-epidemiological method and for self-education in this field throughout their professional life. Through the relationship of the contents of this discipline with health problems, academic commitment, self-directed, meaningful and active learning are strengthened, as well as academic performance, motivation and participation, which offers satisfaction and well-being to the student in a context in the than chronic disease not transmissible they constitute one of the bigger challenges that confront the systems of worldwide health.

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OBJECTIVES: To describe the self-reported health problems and quality of life among adult-aged Colombian childhood and adolescent cancer survivors. METHODS: This is a descriptive cross-sectional study with Colombian childhood cancer survivors (CCS) who were diagnosed before the age of 18, at the moment of study were ≥18 years, and at least 5 years had passed since diagnosis. Each participant completed a self-reported study-specific online questionnaire along with the SF-36 Health Survey to assess the prevalence of health problems and current quality of life (QoL). Data were analyzed using descriptive statistics and independent sample t-tests. RESULTS: Out of the 122 CCS who participated, 100% reported at least one health problem, mostly gastritis, headaches, and lack of concentration, followed by obesity and fertility issues. In general, they had a good perception of their QoL, which was, on average, only diminished in the areas of vitality, emotional role functioning, and social functioning. CONCLUSION: Perceived health problems among the participating Colombian CCS were prevalent; most reported a good self-perceived QoL. This is the first study on understanding health problems and QoL of CCS treated in Colombia and South America. It reopens the debate on the need to carry out long-term follow-up in this population among Colombian society.

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Background: Population-based data on epidemiology of Inflammatory Bowel Diseases (IBD) in Brazil are scarce. This study aims to define temporal trends of incidence and prevalence rates of Crohn's disease (CD) and ulcerative colitis (UC) in Brazil. Methods: All IBD patients from the public healthcare national system were included from January 2012 to December 2020. Average Annual Percent Change (AAPC) and 95% confidence intervals (CI) were calculated using log-linear regression for incidence and binomial regression for prevalence. Moran's I autocorrelation index was used to analyse clustering of cities by level of prevalence. Findings: A total of 212,026 IBD patients were included. Incidence of IBD rose from 9.4 in 2012 to 9.6 per 100,000 in 2020 (AAPC=0.8%; 95% CI -0.37, 1.99); for UC, incidence increased from 5.7 to 6.9 per 100,000 (AAPC=3.0%; 95% CI 1.51, 4.58) and for CD incidence decreased from 3.7 to 2.7 per 100,000 (AAPC=-3.2%; 95% CI -4.45, -2.02). Prevalence of IBD increased from 30.0 in 2012 to 100.1 per 100,000 in 2020 (AAPC=14.8%; CI 14.78-14.95); for UC, from 15.7 to 56.5 per 100,000 (AAPC=16.0%; CI 15.94, 16.17); for CD from 12.6 to 33.7 per 100,000 (AAPC=12.1% CI 11.95, 12.02). A south-north gradient was observed in 2020 prevalence rates of IBD [I=0.40 (p<0.0001)], CD [I=0.22 (p<0.0001)] and UC [I=0.42 (p<0.0001)]. Interpretation: Incidence of CD is decreasing whereas of UC is increasing, leading to stabilization in the incidence of IBD from 2012 to 2020 in Brazil. Prevalence of IBD has been climbing with 0.1% of Brazilians living with IBD in 2020. Funding: None.

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Automobile security became an essential theme over the last years, and some automakers invested much money for collision avoidance systems, but personalization of their driving systems based on the user's behavior was not explored in detail. Furthermore, efficiency gains could be had with tailored systems. In Mexico, 80% of automobile accidents are caused by human beings; the remaining 20% are related to other issues such as mechanical problems. Thus, 80% represents a significant opportunity to improve safety and explore driving efficiency gains. Moreover, when driving aggressively, it could be connected with mental health as a post-traumatic stress disorder. This paper proposes a Tailored Collision Mitigation Braking System, which evaluates the driver's personality driving treats through signal detection theory to create a cognitive map that understands the driving personality of the driver. In this way, aggressive driving can be detected; the system is then trained to recognize the personality trait of the driver and select the appropriate stimuli to achieve the optimal driving output. As a result, when aggressive driving is detected continuously, an automatic alert could be sent to the health specialists regarding particular risky behavior linked with mental problems or drug consumption. Thus, the driving profile test could also be used as a detector for health problems.

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OBJECTIVE: The objective was to determine and compare demographic features, professional activities and adversities, physical health conditions, and self-care behaviors related to the most frequently self-reported mental health problems among psychiatrists and psychiatry trainees. METHODS: A cross-sectional, retrospective, comparative study was conducted on a total of 330 (48.2%) psychiatry trainees and 355 (51.8%) psychiatrists from Mexico through an online survey. Demographic features, professional activities and adversities, physical and mental health problems, self-care behaviors, and social support were examined. Comparative analyses and multiple logistic regression models were performed. RESULTS: Major depression, anxiety, and burnout were the most common mental health problems reported with a higher frequency of anxiety disorders in psychiatry trainees. Being a woman, having a physical health problem, and lack of restful sleep were the main risk factors in both groups. Consultation in the government sector and having patients with severe suicidal ideation affected more psychiatry trainees. Perceived discrimination and inadequate eating schedules were risk factors for mental health problems for psychiatrists. CONCLUSION: Psychiatry trainees constitute a vulnerable group for anxiety disorders. Particular attention should be paid to how students cope with the training experience to determine whether additional support is required. These professionals face major stressors leading to a high prevalence of depression, burnout, and anxiety. Encouraging psychiatrists to have better health habits is a step in the right direction, which must be accompanied by tangible organizational avenues to do so and creating a culture that truly promotes self-care.

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Introducción: El daño al medio ambiente es cada vez mayor, los problemas ambientales globales crecen por día, ya sea por causas naturales o antrópicas. Esto provoca la aparición y agravamiento de diversas enfermedades por lo que existe una relación entre los problemas ambientales y los problemas de salud. Por esta razón los médicos deben conocer profundamente dicha relación lo que permitirá desempeñar mejor sus variadas funciones y entre ellas las educativas. Objetivo: Evaluar el nivel de conocimientos sobre la dimensión ambiental en estudiantes de sexto año de la carrera de Medicina y residentes de primer año de Medicina General Integral. Métodos: Se aplicó una encuesta de conocimientos, a través de la plataforma Moodle, sobre conceptos, factores y problemas relacionados con el medio ambiente y sus vínculos con problemas de salud, a 32 estudiantes de sexto año terminado de la carrera de Medicina correspondiente al 35,55 por ciento del total de la matrícula, así como a 29 residentes de medicina general integral también con primer año de la residencia finalizado para un 55,76 por ciento de los matriculados. Las muestras pertenecientes a las facultades de ciencias médicas Manuel Fajardo y Salvador Allende se seleccionaron de forma aleatoria. Resultados: El resultado general de la encuesta fue de un 21,88 por ciento de aprobados para los estudiantes y de un 27,59 por ciento para los residentes. Estos concordaron con un bajo porciento de aciertos en diferentes preguntas, por ejemplo, las que exploraron conceptos importantes como medio ambiente y desarrollo sostenible, así como la de los problemas ambientales de Cuba y sus efectos, como el deterioro de la condición higiénico-sanitaria (ambientales) en los asentamientos humanos, entre otros. Conclusiones: El nivel de conocimiento mostrado por los estudiantes y los residentes, acerca de la dimensión ambiental, evidencia insuficiencias cognoscitivas en esta esfera y en su relación con la actividad profesional(AU)

Introduction: Environmental damage is increasing over time; global environmental problems are growing every day, whether due to natural or man-made causes. This brings about the appearance and worsening of various diseases, based on the relationship between environmental problems and health problems. For this reason, physicians must have deep understanding of this relationship, which will allow them to carry out their various functions better, including educational ones. Objective: To assess, in sixth-year medical students and in first-year residents of Family Medicine, their level of knowledge about the environmental dimension. Methods: A knowledge survey was applied, using the Moodle platform, about concepts, factors and problems related to the environment and their links with health problems. The respondents were 32 students in the sixth academic year of the Medicine major, a figure accounting for 35.55 percent of the total enrollment; as well as 29 Family Medicine residents also with the first academic year of their residency completed, which accounted for 55.76 percent of those enrolled. The samples belonging to Manuel Fajardo and Salvador Allende medical schools were randomly selected. Results: The general result of the survey was 21.88 percent of approved respondents for students and 27.59 percent for residents. These coincided with a low percentage of correct answers in different questions; for example, those that explored important concepts such as environment and sustainable development, as well as that of Cuba's environmental problems and their effects, such as the deterioration of the hygienic-sanitary condition (environmental) in human settlements, among others. Conclusions: The level of knowledge shown by students and residents about the environmental dimension shows cognitive deficiencies in this sphere and in its relationship with professional activity(AU)

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BACKGROUND: Confinement during the COVID-19 pandemic has placed great stress on older adults, which may be affecting their quality of life. Thus, this study aims to describe the changes in mental and physical health, isolation and loneliness, residence and socioeconomic resources in a national cohort of Chilean older adults before and during the COVID-19 outbreak. It also analyzes the changes in depressive symptoms by changes in the other quality of life indicators before and during the COVID-19 outbreak. Possible methodological biases of telephone surveys in older adults living in non-developed countries are also discussed. METHODS: Between June and September 2020, a random subsample of 720 people who had participated in the face-to-face V National Survey on Quality of Life in Older Adults in Chile conducted at the end of 2019 was followed up by telephone. Descriptive bivariate analyses were performed using t-test and non-parametric tests for independent variables, comparing the baseline sample with the current 2020 follow-up sample during the peak of the pandemic outbreak in Latin America. Furthermore, descriptive bivariate analysis through t-test and non-parametric test for paired samples compared the follow-up subsample at baseline with the not-included sample, examining possible biases of the telephone interview compared with the face-to-face interview. RESULTS: In the panel, there was no variation in self-rated health. The health symptoms that worsened were memory, stomach, and mood problems. Depressive symptoms and anxiety increased; similarly, smartphone users, social contacts, intergenerational co-residence and resilience increased. The telephone follow-up sample had a higher educational level and greater smartphone use than those not included in the subsample. CONCLUSIONS: Although some physical and mental health indicators have worsened during the pandemic, older adults mobilized resources that could allow them to maintain their quality of life, such as improved resilience. Thus, these findings can guide future research and the development of efficient strategies to improve these resources among older adults to ensure wellbeing.

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ABSTRACT BACKGROUND: Neck pain is a major public health problem. OBJECTIVE: The aim of the present study was to determine the prevalence of neck pain among high school students and to analyze associations with sociodemographic variables, use of electronic devices, habitual physical activity practices and mental health problems. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of high school students in the city of Bauru, São Paulo, Brazil. METHOD: Participants were selected through cluster sampling in two stages and data were collected via face-to-face interviews. Data collection comprised the following steps: 1. sociodemographic characteristics; 2. use of electronic devices; 3. habitual physical activity levels; 3. mental health; and 4. neck pain. RESULTS: A total of 1,628 participants were interviewed. The prevalence of neck pain was 49.1% (95% confidence interval, CI 46.7 to 51.5), with 40.4% (95% CI 37.0 to 43.7) in men and 57.5% (95% CI 54.2 to 60.9) in women. The variables associated with in neck pain were: female (prevalence ratio, PR = 2.04), use of cell phone in standing posture (PR = 1.47), use of tablet in sitting posture (PR = 1.72), length of computer use greater than 3 hours/day (PR = 1.54), length of cell phone use greater than 3 hours/day (PR = 1.54), length of tablet use greater than 3 hours/ day (PR = 1.34) and mental health problems (PR = 1.56). CONCLUSION: There is high prevalence of neck pain among students and striking associations with female sex, use of electronic devices and mental health problems.

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The article contains an analysis of the marketing authorizations and the consumption of pesticides in the last decade, as well as their effects on human health and the environment. In the period between 2010 and 2018, the amount of pesticides sold in Brazil increased more than twice as much as the cultivated area in the country. The permissiveness of pesticide governance in Brazil is illustrated by the fact that, of the total chemical active ingredients with register in the country in July 2020, 121 (30.0%) had no use allowed in the European Union (EU). The reason for the ban on the use in the EU of products authorized in Brazil, in the referred period, is associated with the adverse effects on humans and other organisms resulting from exposure to chemical ingredients of pesticides, already described in the scientific literature. Soybean, corn, cotton and sugar cane are among those that had the largest number of new pesticides authorized for use in Brazil between January 2019 and June 2020. Another lack of rigor in pesticide governance is illustrated by the drift, which causes acute and chronic damage to third parties. Another weakness of the Brazilian standard refers to the establishment of a dose value, below which, they would be safe. However, experimental results from studies have shown, for example, that pesticides based on glyphosate, melation and pyriproxifem caused the death of fish embryos in just 24 hours of exposure, regardless of the concentration used, challenging the hypotheses that there is safe dose for exposure to such pesticides. Thus, it is urgent that there is a need not only to increase the scientific rigor of the studies on the subject, but also to promote the public participation in decisionmaking process ensuring the access to all information contained in the dossiers accompanying requests for registration and authorization

artigo contém uma análise das autorizações para a comercialização e o consumo de agrotóxicos no país na última década, bem como os seus efeitos na saúde humana e no meio ambiente. No período entre 2010 e 2018, a quantidade de agrotóxicos comercializados no Brasil aumentou mais do que o dobro do que cresceu a área cultivada no país. A permissividade da gestão de agrotóxicos no Brasil é ilustrada pelo fato de que, do total de ingredientes ativos químicos com registro no país em julho de 2020, 121 (30%) não tinham uso permitido na União Europeia (EU). A razão da proibição do uso na EU dos produtos autorizados no Brasil, no período referido, está associada aos efeitos adversos a humanos e a outros organismos resultantes da exposição aos ingredientes químicos de agrotóxicos, já descritos na literatura científica. Soja, milho, algodão e cana-de-açúcar constam entre as culturas que tiveram o maior número de novos agrotóxicos com uso autorizado no Brasil entre janeiro de 2019 e junho de 2020. Outra falta de rigor na gestão de agrotóxicos é ilustrada pela deriva, que causa danos agudos e crônicos a terceiros. Adicionalmente, a fragilidade da norma brasileira refere-se ao estabelecimento de um valor de dose, abaixo da qual eles seriam seguros. Contudo, resultados experimentais de estudos mostraram, por exemplo, que os agrotóxicos à base de glifosato, melation e piriproxifem causaram a morte de embriões de peixes em apenas 24 horas de exposição, independentemente da concentração utilizada, desafiando assim a hipótese de que existe dose segura para a exposição a tais produtos. Dessa forma, é urgente não só aumentar o rigor científico dos estudos sobre o tema, mas também promover a participação pública nas tomadas de decisão, garantindo o acesso a todas as informações contidas nos dossiês que acompanham as solicitações de registro e de autorização dos agrotóxicos.

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El deterioro del medio ambiente es un hecho indiscutible. Se llama a la comunidad internacional, a los Gobiernos y pueblos a frenar el daño causado y a colaborar con la recuperación. No obstante, el perjuicio resulta cada vez mayor. Diversos problemas naturales destruyen la Tierra, también los causados por el ser humano, como el cambio climático y la contaminación, cuyas nefastas consecuencias generan y agravan los problemas de salud vegetal, animal y humana. El cambio climático influye en el comportamiento de enfermedades transmisibles y no transmisibles. La contaminación, a través de contaminantes ambientales, como los disruptores endocrinos, pueden conllevar a la aparición de enfermedades crónicas. A pesar de que estas condiciones afectan al medio ambiente y en particular al hombre, no existe una verdadera conciencia ambiental, por lo que cabe preguntarse: ¿por qué persiste esta situación a pesar de los esfuerzos realizados y de la divulgación de esta problemática no solo en Cuba sino también a nivel mundial? Los insuficientes conocimientos de la temática ambiental y su no interiorización influyen en la falta de conciencia, por eso es imprescindible impartirlos en la carrera de medicina para lograr una verdadera formación en esta esfera, que contribuya con el desarrollo de una conciencia ambiental en la población, pues una de las funciones del médico es educar. Cuba tiene potencialidades que le permiten enfrentar los problemas ambientales que atentan contra el desarrollo socioeconómico, en general, y contra la vida, en particular, para así poder lograr un desarrollo humano sostenible(AU)

Environmental degradation is an indisputable fact. The international community, governments and peoples are called upon to stop the damage caused and to collaborate with its recovery. However, the damage is increasing. Various natural problems destroy the Earth; also those caused by humans, such as climate change and pollution, whose dire consequences generate and aggravate plant health, animal health and human health problems. Climate change influences the behavior of communicable and non-communicable diseases. Pollution, through environmental pollutants, such as endocrine disruptors, can lead to the appearance of chronic diseases. Despite the fact that these conditions affect the environment and the human being in particular, there is no true environmental awareness, so it is worth asking: Why does this situation persist despite efforts made and the disclosure of this problem not only in Cuba but also worldwide? Insufficient knowledge about environmental issues and its lack of internalization influence the lack of awareness; that is why, it is essential to teach them in the medical major, in order to achieve real training in this area, which contributes to the development of environmental awareness among the population, because one of the functions of the physician is to educate. Cuba has potential resources that allows to face environmental problems that threaten socioeconomic development, in general, and against life, in particular, in order to achieve sustainable human development(AU)

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RESUMEN Introducción: La investigación persigue el objetivo de determinar la respuesta social ante las medidas tomadas para el enfrentamiento a la COVID-19 en la provincia de Camagüey. Clasificada como investigación-desarrollo del Centro de Desarrollo de las Ciencias Sociales y Humanísticas en Salud fue realizada en el período de abril - julio 2020. Material y Métodos: Se utilizó el cuestionario asistido para recolectar información sobre la respuesta social ante la enfermedad. Fue aplicado al unísono en el territorio en el período de 5 de mayo al 30 de junio, cuando aún Camagüey no había pasado a la primera fase de recuperación, se tuvo como criterio asignar cuotas para abarcar todos los municipios de la provincia y aplicar en la población de modo aleatorio. A partir de las medidas tomadas de aislamiento social se utilizó la pesquisa activa de los estudiantes y profesores de la Universidad de Ciencias Médicas para la recogida de información. La muestra final quedó conformada por 603 personas encuestadas. Resultados: La población encuestada valoró el esfuerzo y la voluntad política y consideró adecuada la respuesta al enfrentamiento de la enfermedad también se valoró adecuada las acciones de las diversas instituciones en el enfrentamiento a la COVID-19. Discusión: Resulta significativo que los sujetos que participaron en el estudio reconocieran problemas con el cumplimiento del aislamiento y la responsabilidad social, con la distribución equitativa de los recursos y la necesidad de fortalecer las medidas de control social ante las indisciplinas sociales.

ABSTRACT Introduction: The investigation pursues the objective of determining the social response to the measures taken to confront COVID-19 in the province of Camagüey. Classified as research-development of the Center for the Development of Social and Humanistic Sciences in Health, it was carried out in the period from April - July 2020. Material and methods: The assisted questionnaire was used to collect information on the social response to the disease. It was applied in unison in the territory in the period from May 5 to June 30, when Camagüey had not yet passed to the first recovery phase, the criterion was to assign quotas to cover all the municipalities of the province and apply in the population randomly. Based on the measures taken of social isolation, the active research of the students and professors of the University of Medical Sciences was used to collect information. The final sample was made up of 603 people surveyed. Results: The surveyed population valued the effort and political will and considered the response to the confrontation of the disease adequate, the actions of the various institutions in the confrontation with COVID-19 were also considered adequate. Discussion: It is significant that the subjects who participated in the study recognized problems with compliance with isolation and social responsibility, with the equitable distribution of resources and the need to strengthen social control measures in the face of social indiscipline.