RESUMO
The transition towards Circular Economy (CE) is a promising approach to sustainable development that may cause significant social impacts. Despite the benefits of CE initiatives, key players such as informal recyclers face serious social issues such as poverty, lack of social security, and discrimination. Although evaluating social impacts remains a considerable challenge, Social Life Cycle Assessment (SLCA) is recognized as a suitable methodology with a life cycle perspective. While most SLCA experiences are conducted in the formal sector, it is important to consider the informal sector, which plays a crucial role in developing countries. This article presents an analysis of SLCA studies in informal recycling settings in order to identify the challenges and adjustments required for informal settings. The analysis is based on a literature review and a documentary review of a pilot application of SLCA in the informal recycling system in Cuenca, Ecuador. The results show that SLCA requires adaptation to be applied in informal settings. There are particular challenges in delineating boundaries due to the fuzzy nature and variability of informal activities. Tasks such as establishing specific indicators, developing reference scales and data collection, require careful planning and active stakeholder participation. For instance, indicators regarding Fair Salary or Working hours were adapted based on best practices. Furthermore, tasks such as verifying and disseminating results should be included in interpretation phases to generate long-term impacts and influence behaviors. The study underscores SLCA's multidimensional view but highlights the need for further standardization and adaptation for informal sectors.
Assuntos
Reciclagem , Reciclagem/métodos , Humanos , Equador , Setor Informal , Gerenciamento de Resíduos/métodos , Desenvolvimento SustentávelRESUMO
PURPOSE: Breast density is a significant risk factor for breast cancer and can impact the sensitivity of screening mammography. Area-based breast density measurements may not provide an accurate representation of the tissue distribution, therefore volumetric breast density (VBD) measurements are preferred. Dual-energy mammography enables volumetric measurements without additional assumptions about breast shape. In this work we evaluated the performance of a dual-energy decomposition technique for determining VBD by applying it to virtual anthropomorphic phantoms. METHODS: The dual-energy decomposition formalism was used to quantify VBD on simulated dual-energy images of anthropomorphic virtual phantoms with known tissue distributions. We simulated 150 phantoms with volumes ranging from 50 to 709 mL and VBD ranging from 15% to 60%. Using these results, we validated a correction for the presence of skin and assessed the method's intrinsic bias and variability. As a proof of concept, the method was applied to 14 sets of clinical dual-energy images, and the resulting breast densities were compared to magnetic resonance imaging (MRI) measurements. RESULTS: Virtual phantom VBD measurements exhibited a strong correlation (Pearson's r > 0.95 $r > 0.95$ ) with nominal values. The proposed skin correction eliminated the variability due to breast size and reduced the bias in VBD to a constant value of -2%. Disagreement between clinical VBD measurements using MRI and dual-energy mammography was under 10%, and the difference in the distributions was statistically non-significant. VBD measurements in both modalities had a moderate correlation (Spearman's ρ $\rho \ $ = 0.68). CONCLUSIONS: Our results in virtual phantoms indicate that the material decomposition method can produce accurate VBD measurements if the presence of a third material (skin) is considered. The results from our proof of concept showed agreement between MRI and dual-energy mammography VBD. Assessment of VBD using dual-energy images could provide complementary information in dual-energy mammography and tomosynthesis examinations.
Assuntos
Densidade da Mama , Neoplasias da Mama , Mamografia , Imagens de Fantasmas , Imagem Radiográfica a Partir de Emissão de Duplo Fóton , Humanos , Mamografia/métodos , Feminino , Neoplasias da Mama/diagnóstico por imagem , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Mama/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Imageamento por Ressonância Magnética/métodosRESUMO
BACKGROUND: Vaccination against COVID-19 is a primary tool for controlling the pandemic. However, the spread of vaccine hesitancy constitutes a significant threat to reverse progress in preventing the disease. Studies conducted in Mexico have revealed that vaccination intention in Mexico among the general population ranges from 62 to 82%. OBJECTIVE: To know the prevalence of COVID-19 vaccine hesitancy and associated factors among academics, students, and administrative personnel of a public university in Mexico City. METHODS: We administered an online survey investigating sociodemographic aspects, knowledge, attitudes, practices, and acceptance/hesitancy regarding the COVID-19 vaccine. Using generalized linear Poisson models, we analyzed factors associated with vaccine hesitancy, defined as not intending to be vaccinated within the following six months or refusing vaccination. RESULTS: During May and June 2021, we studied 840 people, prevalence of vaccine hesitancy was 6%. Hesitancy was significantly associated with fear of adverse effects, distrust of physician's recommendations, lack of knowledge regarding handwashing, age younger than 40 years, refusal to use face masks, and not having received influenza vaccination during the two previous seasons. CONCLUSIONS: Vaccine hesitancy in this population is low. Furthermore, our results allowed us the identification of characteristics that can improve vaccine promotion.
Assuntos
COVID-19 , Vacinas , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , México/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Universidades , VacinaçãoRESUMO
Sesamoiditis secondary to gout is an extremely rare condition with few case reports in the literature. It is an important differential diagnosis because the treatment depends on targeted therapy, unlike the main causes of sesamoiditis that often involves immobilization with special orthoses and prescription of anti-inflammatory drugs. We report here a case of a 38-year-old male, athlete, with bipartite medial sesamoid, who had insidious pain in the base of the left hallux. Laboratory tests showed no alterations, and imaging examinations demonstrated sesamoiditis with suspicion of stress fracture. The patient was initially prescribed an immobilization boot and analgesic and anti-inflammatory drugs, but he did not respond to the measures taken. After the onset of the same condition in the contralateral foot and getting the same imaging findings, we began an investigation of systemic disease, focusing on gout, because of a positive family history, which was confirmed by dual-energy computed tomography.
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BACKGROUND: On January 23, 2020, China imposed a quarantine on the city of Wuhan to contain the SARS-CoV-2 outbreak. Regardless of this measure, the new infection has spread to several countries around the world. OBJECTIVE: We developed a method to study the dissemination of this infection by airline routes and provide estimations of the time of arrival of the outbreak to different cities. METHODS: Using the Kermack and McKendrick model complemented with diffusion on a graph composed of nodes and edges, we made an analysis of COVID-19 dispersion to other cities by air travel. RESULTS: The estimation was accurate in that it was possible to predict in the middle of February 2020 the arrival of the first outbreak in Mexico, which eventually occurred between March 20 and 30. This estimation was robust with respect to small changes in epidemiological parameters at the other nodes. CONCLUSIONS: The estimation of the time of arrival of the outbreak from its epicenter, allows for a time period to implement and strengthen preventive measures aimed at the general population as well as to strengthen hospital infrastructure and training of human resources. In the present study, this estimation was accurate, as observed from the real data of the beginning of the outbreak in Mexico City up to April 6, 2020.
Assuntos
Viagem Aérea , Betacoronavirus , Infecções por Coronavirus/transmissão , Pandemias , Pneumonia Viral/transmissão , Doença Relacionada a Viagens , COVID-19 , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Geografia Médica , Humanos , México/epidemiologia , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , SARS-CoV-2 , Fatores de Tempo , Saúde da População UrbanaRESUMO
ABSTRACT Background: On January 23, 2020, China imposed a quarantine on the city of Wuhan to contain the SARS-CoV-2 outbreak. Regardless of this measure, the new infection has spread to several countries around the world. Objective: We developed a method to study the dissemination of this infection by airline routes and provide estimations of the time of arrival of the outbreak to different cities. Methods: Using the Kermack and McKendrick model complemented with diffusion on a graph composed of nodes and edges, we made an analysis of COVID-19 dispersion to other cities by air travel. Results: The estimation was accurate in that it was possible to predict in the middle of February 2020 the arrival of the first outbreak in Mexico, which eventually occurred between March 20 and 30. This estimation was robust with respect to small changes in epidemiological parameters at the other nodes. Conclusions: The estimation of the time of arrival of the outbreak from its epicenter, allows for a time period to implement and strengthen preventive measures aimed at the general population as well as to strengthen hospital infrastructure and training of human resources. In the present study, this estimation was accurate, as observed from the real data of the beginning of the outbreak in Mexico City up to April 6, 2020.
Assuntos
Humanos , Pneumonia Viral/transmissão , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , Viagem Aérea , Betacoronavirus , Doença Relacionada a Viagens , Pneumonia Viral/epidemiologia , Fatores de Tempo , China/epidemiologia , Saúde da População Urbana , Surtos de Doenças/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/epidemiologia , Geografia Médica , SARS-CoV-2 , COVID-19 , México/epidemiologia , Modelos TeóricosRESUMO
Justificación:Las fallas relacionadas a la actuación profesional, impactan negativamente a los pacientes e incluso pueden conducirlos a la muerte. Las denuncias constituyen un mecanismo por el que los pacientes o sus familiares expresan insatisfacción, y cuando se analizan, sistemáticamente, no solo desde la perspectiva legal, constituyen una oportunidad de mejora continua. Objetivo:Caracterizar las denuncias por responsabilidad profesional médica dictaminadas en la Dirección de Medicina Forense de Tegucigalpa. Metodología:Se realizó un estudio descriptivo de 89 denuncias por responsabilidad profesional médica, entre el 2010 y el 2015 dictaminadas en la Dirección de Medicina Forense de Tegucigalpa, siendo las variables de estudio: De las víctimas: edad, sexo, escolaridad. De los denunciantes: edad, sexo, motivo de la denuncia, relación con la víctima, procedencia. Del denunciado: Edad, sexo, centro donde laboraba, tiempo de laborar y especialidad ejercida. Resultados:El 5,61% de las denuncias correspondieron a casos de responsabilidad profesional médica, 20% de las cuales fueron por desconocimiento inexcusable y 80% por omisión de cuidados. Ginecobstetricia fue la especialidad más denunciada con el 30%. Los médicos más denunciados (77,6%) trabajaban en una institución pública, y el conflicto en la relación médico-paciente fue la causa de denuncia más frecuente (40.4%). Conclusión:Los médicos del sexomasculino, cercanos a los 50 años de edad y con más de 15 años de experiencia, que laboraban encentros públicos y que ejercían las especialidadesde Ginecobstetricia, OrtopediayCirugía General, fueron los más denunciados; entre los motivos más frecuentes dedenuncia se citaron losconflictos en la relación médico-paciente-familiar, la inconformidad en el diagnóstico y falta de ética profesional de otros profesionales con comentarios adversos hacia sus colegas o las instituciones...(AU)
Assuntos
Humanos , Responsabilidade Legal , Medicina Legal/ética , Relações Médico-Paciente , Denúncia de Irregularidades/legislação & jurisprudênciaRESUMO
A maior parte das exportações de laranja do Brasil(98%) são feitas pelas empresas associadas da CitrusBR, composta por CitroSuco, Cutrale e Louis Dreyfus Company (ABRAHÃO, L. P., LOHBAUER C., 2012). Assim, diante da importância da exportação para a cadeia da citricultura nacional, este estudo busca entender o recente posicionamento estratégico da empresa no mercado europeu, que tem o objetivo de aumentar a demanda pelo suco de laranja, promovendo mudanças de hábitos e percepções.(AU)
Assuntos
Humanos , Planejamento Estratégico , Sucos de Frutas e Vegetais/economia , Exportação de Produtos , Marketing , Europa (Continente) , Citrus sinensisRESUMO
A maior parte das exportações de laranja do Brasil(98%) são feitas pelas empresas associadas da CitrusBR, composta por CitroSuco, Cutrale e Louis Dreyfus Company (ABRAHÃO, L. P., LOHBAUER C., 2012). Assim, diante da importância da exportação para a cadeia da citricultura nacional, este estudo busca entender o recente posicionamento estratégico da empresa no mercado europeu, que tem o objetivo de aumentar a demanda pelo suco de laranja, promovendo mudanças de hábitos e percepções.
Assuntos
Humanos , Exportação de Produtos , Marketing , Planejamento Estratégico , Sucos de Frutas e Vegetais/economia , Citrus sinensis , Europa (Continente)RESUMO
El maltrato infantil es un importante problema de salud pública que afecta la salud y vida de las víctimas, que está presente en todas las culturas y estratos socio económicos y que tiene graves consecuencias de salud para las víctimas. Este estudio caracterizó al niño maltratado evaluado en la Clínica Forense de Tegucigalpa, el período 2010 al 2015. Mediante un estudio descriptivo, retrospectivo; se analizaron 267 casos de maltrato infantil. El 95.5% presentó maltrato físico por transgresión. Las características relevantes de las víctimas de maltrato infantil fueron: En su mayoría niñas (57,3%) (t=2,408, df=266, pvalor=0,016), escolares, con 8.6 años de edad promedio, el 46% convivían en el seno de su familia nuclear, el 84,3% fueron agredidas en su vivienda, la madre fue la principal agresora. El maltrato físico por transgresión fue el más reportado, y el cinturón el principal objeto de agresión
Assuntos
Humanos , Masculino , Feminino , Criança , Maus-Tratos Infantis , Violência Doméstica/psicologia , Pobreza/estatística & dados numéricos , Queimaduras , Fraturas ÓsseasRESUMO
Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite, Trypanosoma cruzi. The main mode of transmission of this disease in endemic areas is through an insect vector called triatomine bug. Triatomines become infected with T. cruzi by feeding blood of an infected person or animal. Chagas disease is considered the most important vector borne infection in Latin America. It is estimated that between 16 and 18 millions of persons are infected with T. cruzi, and at least 20,000 deaths each year. In this work we formulate a model for the transmission of this infection among humans, vectors and domestic mammals. Our main objective is to assess the effectiveness of Chagas disease control measures. For this, we do sensitivity analysis of the basic reproductive number R0 and the endemic proportions with respect to epidemiological and demographic parameters.
Assuntos
Doença de Chagas/transmissão , Insetos Vetores/parasitologia , Triatominae/parasitologia , Trypanosoma cruzi/crescimento & desenvolvimento , Animais , Doença de Chagas/epidemiologia , Doença de Chagas/prevenção & controle , Simulação por Computador , Humanos , Controle de Insetos/normas , América Latina/epidemiologia , Modelos Biológicos , População RuralRESUMO
Se describe la evolución de la epidemia causada por la infección del virus de inmunodeficiencia humana, cuyo estado final lo constituye el síndrome de inmunodeficiencia adquirida, desde sus inicios hasta la actualidad, con especial énfasis en la repercusión que ha tenido para el desarrollo de la humanidad en el ámbito social.
The clinical course of the epidemic caused by the infection of the human immunodeficiency virus whose final state is the acquired immunodeficiency syndrome, from its beginning up to the present time, with special emphasis on the repercussion that it has had for the humanity's development in the social environment is described.
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Avaliação de Danos no Setor Social , Infecções por HIV , Indicadores SociaisRESUMO
Encephalopathy is an important cause of morbidity and mortality in patients with severe hepatic failure and the mechanisms underlying hepatic encephalopathy are still not fully known. Considering that creatine kinase (CK) play a crucial role in brain energy homeostasis and is inhibited by free radicals, and that oxidative stress is probably involved in the pathogenesis of hepatic encephalopathy, we evaluated CK activity in hippocampus, striatum, cerebellum, cerebral cortex and prefrontal cortex of rats submitted to acute administration of carbon tetrachloride or acetaminophen. The effects of the administration of antioxidants, N-acetylcysteine (NAC) plus deferoxamine (DFX) in association, and taurine, were also evaluated. Our findings demonstrated that carbon tetrachloride inhibited CK activity in cerebellum; acetaminophen inhibited the enzyme in cerebellum and hippocampus. CK activity was not affected in other brain areas. The administration of NAC plus DFX reversed the inhibition of CK activity caused by carbon tetrachloride in cerebellum and by acetaminophen in cerebellum and hippocampus. On the other hand, taurine was not able to reverse the inhibition in CK activity. Although it is difficult to extrapolate our findings to the human condition, the inhibition of brain CK activity after hepatic failure may be involved in the pathogenesis of hepatic encephalopathy.
Assuntos
Acetaminofen/toxicidade , Analgésicos não Narcóticos/toxicidade , Encéfalo/enzimologia , Intoxicação por Tetracloreto de Carbono/enzimologia , Doença Hepática Induzida por Substâncias e Drogas/enzimologia , Creatina Quinase/antagonistas & inibidores , Creatina Quinase/metabolismo , Falência Hepática/enzimologia , Alanina Transaminase/antagonistas & inibidores , Alanina Transaminase/metabolismo , Animais , Antioxidantes/farmacologia , Cerebelo/efeitos dos fármacos , Cerebelo/enzimologia , Metabolismo Energético/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Hipocampo/enzimologia , Testes de Função Renal , Falência Hepática/induzido quimicamente , Masculino , Ratos , Ratos WistarRESUMO
In this paper we analyze the impact of seasonal variations on the dynamics of West Nile Virus infection. We are interested in the generation of new epidemic peaks starting from an endemic state. In many cases, the oscillations generated by seasonality in the dynamics of the infection are too small to be observable. The interplay of this seasonality with the epidemic oscillations can generate new outbreaks starting from the endemic state through a mechanism of parametric resonance. Using experimental data we present specific cases where this phenomenon is numerically observed.
Assuntos
Surtos de Doenças , Modelos Biológicos , Estações do Ano , Febre do Nilo Ocidental/epidemiologia , Algoritmos , Animais , Número Básico de Reprodução , Aves/fisiologia , Aves/virologia , Simulação por Computador , Culicidae/fisiologia , Culicidae/virologia , Doenças Endêmicas , Humanos , Insetos Vetores/fisiologia , Insetos Vetores/virologia , Dinâmica não Linear , Dinâmica Populacional , Febre do Nilo Ocidental/transmissãoRESUMO
In this work we formulate and analyze a mathematical model for the transmission of West Nile Virus (WNV) infection between vector (mosquito) and avian population. We find the Basic Reproductive Number R0 in terms of measurable epidemiological and demographic parameters. R0 is the threshold condition that determines the dynamics of WNV infection: if R0< or =1 the disease fades out, and for R0 >1 the disease remains endemic. Using experimental and field data we estimate R0 for several species of birds. Numerical simulations of the temporal course of the infected bird proportion show damped oscillations approaching the endemic value.
Assuntos
Doenças das Aves/transmissão , Doenças das Aves/virologia , Culex/virologia , Insetos Vetores/virologia , Modelos Biológicos , Febre do Nilo Ocidental/transmissão , Febre do Nilo Ocidental/veterinária , Vírus do Nilo Ocidental/crescimento & desenvolvimento , Animais , Doenças das Aves/epidemiologia , Aves , Simulação por Computador , Humanos , Estados Unidos/epidemiologia , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologia , Zoonoses/epidemiologia , Zoonoses/virologiaRESUMO
A Doença de Ménière foi descrita pela primeira vez por Prosper Ménière no século XIX e ainda nos dias atuais não existem explicações definitivas para a sua etiologia e para a sua fisiopatologia. A tétrade formada por esta doença é constituída de zumbido, vertigem, queda da acuidade auditiva e a sensação de plenitude aural. A faixa etária mais acometida pela doneça de Méniére corresponde à terceira e quinta décadas de vida, sendo de ocorrência pouco comum em crianças. Este relato tem como objetivo demonstrar que a doença de Ménière, mesmo sendo de baixa ocorrência em crianças, pode vir a acometer esta população e o otorrinolaringologista deve estar apto para o diagnóstico e tratamento. Neste relato de caso, uma criança de 11 anos apresentou, após um episódio de edema facial de causa indeterminada associado a sintomas cócleo-vestibilares, um quadro de Doença de Ménière após uma investigação mais minuciosa. O tratamento com drogas depressoras do labirinto e vasodilatadoras promoveram uma melhora sensível, dando fim à sintomatologia.
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Se realizó una investigación en Sistemas y Servicios de Salud (ISS), sobre los reservorios animales y población, durante el primer semestre del 2001en una muestra probabilística en población, ascendente a 392 persona seleccionadas aleatoreamente. Se operacionalizaron las variables cobertura, propensión del medio, vulnerabilidad; para la recogida de información usamos la observación documental de registros, informes estadísticos, historias clínicas además encuestas anónimas de conocimientos, actitudes y practicas. Para evaluar las variables se usaron métodos de ponderación numérica, indicadores y estándares. Las áreas exploradas fueron: agente, reservorio, características físicas de agua y suelo, infestación de roedores, contaminación pecuaria o mixta, tendencia a la inundación y resolutividad ante problemas de contaminación, así como, conocimientos de la población sobre agente, reservorio, vía de transmisión, protección y conducta ante síntomas y/o signos. El análisis estadístico incluyó medidas resúmenes (índices, proporciones), se hicieron estimaciones por intervalos al 95% de confiabilidad y el test de X2 para diferencias de proporciones con un valor de p asociado de 0,05. La información obtenida confirmó baja cobertura de investigación serológica por especies y sectores de la economía, elevada propensión del medio (69.2 % de los consejos populares), alta vulnerabilidad determinada por moderados conocimientos, baja cobertura vacunal y alta exposición.[AU]
Assuntos
Leptospirose/prevenção & controleRESUMO
Se realizó un estudio combinado (cuanti-cualitativo) con el objetivo de medir y comparar la percepción del riesgo sobre las infecciones de trasmisión sexual- virus de inmunodeficiencia humana Sida, entre estudiantes becados cubanos y extranjeros de áreas básicas en la Facultad de Ciencias Médicas Sancti Spíritus, donde se constató que la percepción de riesgo evaluada a través de los conocimientos y prácticas referidas sobre VIH y otras ITS, fue más satisfactoria en los estudiantes extranjeros con relación a los cubanos en la evaluación del período de mayor transmisibilidad del VIH, período de incubación, líquidos corporales donde se encuentran, período de ventana, vía de transmisión, formas más riesgosas de practicar el sexo, personas inmune de contraer dicha infección y su prevención. Los estudiantes cubanos y extranjeros obtuvieron igual evaluación en la orientación a la población sobre la prevención de dichos eventos. En el análisis de costo resulta mucho más económico invertir en promoción y prevención que en el costo de la morbilidad, sin dejar de considerar todos los demás aspectos que llevan implícito dichas patologías.